The Gift of Not Belonging - Rami Kaminski

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Ded i ca tion
In tro duc tion
PART I. THE FOUN DA TIONS OF NON-BE LONG ING
1. What Is an Otro vert?
2. How the World Mis un der stands Otro verts
3. The Meek Rebel
4. The Pseudo Ex tro vert
5. The Cre ative
6. The Em path
PART II. A WORLD MADE FOR JOIN ERS
7. We Are All Born Otro verts
8. A Cul ture That Re wards Join ing
9. The Fal lacy of Fit ting In
PART III. THE VIRTUES OF BE ING AN OTRO VERT
10. Emo tional Self-Suf fi ciency
11. Em pa thy and Con nec tion
12. Con fi dence and Con tent ment
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13. Think ing Out side the Hive
14. The Rich ness of In ner Life
PART IV. THE OTRO VERT LIFE
15. The Otro vert Child
16. Run ning the Gaunt let of Ado les cence
17. Ro man tic Re la tion ships
18. Otro verts at Work
19. Old Age and Death
Con clu sion
Ap pen dix: Are You an Otro vert?
Ac knowl edg ments
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In tro duc tion
How can I be of help to you?”
“What do you think should be your treat ment goals?”
These are usu ally the first ques tions I ask when I sit down with a new
pa tient. Most peo ple do not have an swers to these ques tions at the out set,
which is ex pected. I’m not look ing to get an an swer but rather to em pha size
that the pa tient is in charge of what hap pens next be cause what we are deal‐ 
ing with is their own life. I of ten say, “You are the cap tain, and this is your
ship. I am a nav i ga tor you’ve hired to as sist you in chart ing a course
through a sea un fa mil iar to you but fa mil iar to me since I’ve crossed it nu‐ 
mer ous times.” No mat ter how that jour ney un folds, my de sired goal for my
pa tients is al ways the same. At the end of our work to gether, I want them to
be happy that they are who they are.
On the sur face, that might seem like a mod est goal. But we hu mans
know how dif fi cult it is. So many of us live our lives yearn ing to look like
some one else, to have what an other has, or even to be some one else. As pir‐ 
ing for some thing is not a prob lem in it self. How ever, since we usu ally as‐ 
pire for some thing we con sider bet ter than what we have, many of us are
left with a poor opin ion of who we al ready are and the lives we al ready live.
Some times, the yearn ing to be less like our selves and more like some‐ 
one else is rooted in envy, or am bi tion, or the gen uine de sire to bet ter our‐ 
selves. But of ten, when a pa tient comes to me seek ing trans for ma tion, fur‐ 
ther in spec tion re veals that what they truly want is to be a per son who is
liked and ac cepted: some one who fits in. They have learned that be long ing
is both a virtue and a goal that should be shared by all hu man be ings, when
in fact, be long ing is nei ther: be long ing is merely a feel ing; it does not ex ist
in re al ity as a tan gi ble thing.
Therein un folds one of hu man ity’s great dif fi cul ties: how to man age the
fact that each of us is a unique in di vid ual con stantly chas ing a feel ing that is
di rectly at odds with their in di vid u al ity.
In my forty-plus years as a prac tic ing physi cian and psy chi a trist, my in‐ 
ter ests have taken me from a re mote area in the Sinai desert, where I
worked as the sole physi cian treat ing no madic Bedouin tribes, to run ning
the schizophre nia unit at Mount Sinai Hos pi tal in New York City (from one
Sinai to the other), to be ing ap pointed the med i cal di rec tor for op er a tions in
the New York agency that runs all as pects of men tal health care in the state.
I’ve taught stu dents and res i dents, treated pa tients in the com mu nity and in
aca demic med i cal cen ters (Mount Sinai and then Co lum bia Pres by te rian),
con ducted clin i cal and phar ma co log i cal re search, and al ways main tained an
ac tive pri vate prac tice. All the while, I have con tin ued to de velop my orig i‐ 
nal ther a peu tic phi los o phy.
In my pri vate prac tice in Man hat tan I have worked with nu mer ous peo‐ 
ple from all walks of life. Among them are world lead ers, renowned per‐ 
form ing artists, and pro fes sion als at the top of their fields. Many of them
come to me seek ing to un der stand why they feel so dis con nected from the
peo ple clos est and most fa mil iar to them—friends, col leagues, and even
fam ily. Over the course of our ses sions, it of ten emerges that they have
gone through life feel ing in ca pable of fit ting in. When around oth ers, they
are al ways an ob server but never an ac tual par tic i pant, and re gard less of the
group of peo ple they are with, they never feel like they truly be long. While
most peo ple forge a sense of self in their re la tion to oth ers—they iden tify
first and fore most as a hus band or a mother, a teacher or a leader—these pa‐ 
tients ex pe ri ence life out side the com mu nal hive.
The vast ma jor ity of these peo ple have no psy chi atric di ag no sis. They
are not neu ro di ver gent or on the autism spec trum. They aren’t so cially mal‐ 
ad justed or even so cially anx ious. So why do they strug gle so much with
fit ting in? In rare cases, their so cial dif fi cul ties stem from shy ness or in tro‐ 
ver sion. Oc ca sion ally, they are a re sult of hav ing been marginal ized or “oth‐ 
ered” based on race, gen der ex pres sion, or dis abil ity. But for most of them,
there is an other en tirely dif fer ent ex pla na tion. Af ter many years spent ob‐ 
serv ing and re search ing these char ac ter is tics, I’ve dis cov ered that they are
rooted in a par tic u lar and pre vi ously un rec og nized trait that is present in
peo ple of ev ery eth nic ity, race, and gen der from all parts of the world: one
hall marked by the lack of a com mu nal im pulse or, in other words, an in nate
in abil ity to feel like they be long. It’s a way of be ing I un der stand vis cer ally.
I, too, spent the early part of my life won der ing why I al ways felt so dif‐ 
fer ent from those around me. I was not shunned or re jected. I had friends, I
was funny, and by all ac counts, I was a pop u lar kid. I liked school. I wasn’t
shy, in tro verted, or so cially anx ious, and I en joyed run ning through the end‐ 
less maze of back yards and build ings in the city where I grew up. On the
out side, I seemed like a happy, well-ad justed kid. But on the in side, I felt
like an ugly duck ling. I was partis of ten dif fi cult
even for non-otro verts.
“Not at all!” she de clared, happy to find that a sit u a tion many find hard
was ac tu ally anx i ety free for her. “I like to make pre sen ta tions, and I have
no stage fright.” When I asked her what she tended to do af ter she fin ished
speak ing, I got a typ i cal otro vert an swer: “I usu ally make a bee line to the
bath room and sneak back to my room. I can’t stand cock tail con ver sa tions.”
But the pub lic speak ing it self, no to ri ous for caus ing per for mance anx i ety
among all per son al ity styles, was no prob lem for her at all. This is be cause
stand ing alone at the podium or be ing on stage at an event is an as signed so‐ 
cial role that dif fer en ti ates the otro vert from ev ery one else in the room.
I ex pe ri enced this my self when, at age four teen, I started to vol un teer in
a hos pi tal. It was a hum ble po si tion—I was as signed to roll a small con fec‐ 
tionary cart from room to room sell ing can dies to bedrid den pa tients and
hand ing out news pa pers and small toi letries. It was very sat is fy ing, as the
pa tients looked for ward to the cart’s ar rival—and mine, since I was its
lucky driver. But the real bonus of this vol un teer work was that I got to
wear a white coat, which al lowed me to imag ine that some peo ple might
think I was an un usu ally young doc tor—some kind of prodigy who had
man aged to com plete med i cal school be fore he was old enough drive a car
(in ret ro spect I’m sure no body thought this, but at four teen my imag i na tion
was un lim ited). The only thing that shat tered the fan tasy was the word “vol‐ 
un teer” em broi dered on the breast pocket of the coat. I did ev ery thing to
hide this scar let let ter so that I could play my role to the max i mum. I fash‐ 
ioned an awk ward Woody Allen–es que way of keep ing my hand on my
pocket in or der to ob scure the ev i dence that I was just one of many young
vol un teers rack ing up com mu nity ser vice hours. I must have been quite a
sight: a tall and skinny red head with horn-rimmed glasses walk ing ev ery‐ 
where while hold ing his hand over his heart. But I dis cov ered that stand ing
out in this way made me feel good and con fi dent. It cre ated a clear bound‐ 
ary be tween me and them, which made my ex pe ri ence more man age able.
That said, the role need not be ob vi ous to cre ate in ner calm; it can be an
“un der cover” role, such as a med i cal pro fes sional vis it ing a dif fer ent hos pi‐ 
tal or a pro fes sor on the grounds of a dif fer ent uni ver sity: any thing that af‐ 
firms the otro vert’s sense that they are dif fer ent from those around them.
That knowl edge of their dif fer ence aligns their outer ex pe ri ence with their
in ner one and feels har mo nious in a way that mas querad ing as an ex tro vert
does not.
In look ing back on their pseudo-ex tro verted years, adult otro verts of ten
find it hard to rec on cile their past per for mance with their present ret i cence.
From the mo ment they are freed from the need to per form, the otro vert’s
au then tic self fi nally has space to emerge, which brings them the peace of
mind they need.
Re call that this was very much the case for my pa tient A, whose story
was the first I told you in chap ter 1. Once he was in his twen ties, the point
at which it be comes eas ier for otro verts to be less con spic u ous about not
join ing, he was able to set tle into a very happy life, full of work and re la‐ 
tion ships that he chose on his own terms and that brought him real con nec‐ 
tion and joy.
5
The Cre ative
Creativ ity is the act of mak ing some thing that has not ex isted be fore. It is
of ten said that the great est in no va tions—in art, sci ence, or any other cre‐ 
ative field—are col lab o ra tions: the prod ucts of many gifted minds work ing
to gether. Al though it is true that it of ten takes a vil lage to ad vance cut ting-
edge knowl edge, ex e cute an in no va tive so lu tion, or bring a new idea to
fruition, true cre ativ ity al ways starts with some kind of break through in‐ 
sight, idea, or rev e la tion that tends to be the prod uct of a sin gle mind. As
nov el ist John Stein beck noted, “Our species is the only cre ative species, and
it has only one cre ative in stru ment, the in di vid ual mind and spirit of man.”
Once the mir a cle of cre ation has taken place, the group can ex pand, ex‐ 
tend, and ap ply it, but the col lec tive never in vents any thing. Whether in mu‐ 
sic, art, po etry, math e mat ics, or phi los o phy, “the pre cious ness,” as Stein‐ 
beck puts it, “lies in the lonely mind of a man.” Think of Galileo, van Gogh,
Mozart, or Plato, not to men tion Pythago ras, Eu clid, New ton, Max well,
Ein stein, and Bohr. Each of them broke with reign ing con ven tions to il lu mi‐ 
nate a dif fer ent view of na ture, art, or phi los o phy that left a mark on the
world. And while they were even tu ally joined by many oth ers who adopted
or built on their ideas, those ideas were (at least ini tially) theirs and theirs
alone.
It isn’t easy to con jure up an idea that is not de rived from past con ven‐ 
tions, and there is no for mula for com ing up with rev o lu tion ary dis cov er ies.
But, while we can not cod ify a dis tinct process for think ing, hear ing, or see‐ 
ing some thing as never be fore, we can prob a bly make one as sump tion: it re‐ 
quires be ing un en cum bered by lim its that com mu nal think ing places on the
in di vid ual mind. Be cause this kind of in de pen dent think ing comes nat u rally
to otro verts, many are deeply cre ative.
The dif fer ence be tween a true cre ative and some one who is merely
gifted, artis tic, or even ex cep tional is that the for mer does not aim to be the
best at some thing; they do some thing no other has ever thought to try. As‐ 
tro physi cist Neil de Grasse Tyson has made this his “per sonal phi los o phy in
life,” say ing, “If some body else can do some thing that I am do ing, they
should do it. And what I want to do is find things that would rep re sent a
unique con tri bu tion to the world—the con tri bu tion that only I, and my port‐ 
fo lio of tal ents, can make hap pen. Those are my pri or i ties in life.”
Otro verts are able to make unique con tri bu tions for two rea sons. First of
all, they are not sus cep ti ble to the col lec tive no tions about what makes a
work of art, lit er a ture, mu sic, or any other cre ative en deavor “good.” This is
not be cause the otro verts live as her mits, with out ex po sure to these out side
in flu ences, but rather be cause they are im per vi ous to the opin ions of oth ers,
past or present, when it comes to cre ative de ci sions. They don’t need to
tune out the white noise of those al ter nate per spec tives be cause they rarely
reg is ter these per spec tives in the first place, and even when they do, they
sim ply don’t feel the urge to use them as a means of com par i son. The re sult
is that just the ba sic act of think ing can lead the otro vert to cre ative dis cov‐ 
er ies that un in ten tion ally sub vert the com mu nal wis dom.
Sec ond, otro verts have no need for oth ers’ ap proval or agree ment. When
you are not try ing to con vince oth ers of your work’s merit, and when you
have no fear of judg ment or crit i cism, that is when you get to truly cre ate,
with out in hi bi tion.
The painter Frida Kahlo once said, “I don’t give a shit what the world
thinks. I was born a bitch, I was born a painter, I was born fucked. But I was
happy in my way. You did not un der stand what I am. I am love. I am plea‐ 
sure, I am essence, I am an id iot, I am an al co holic, I am tena cious. I am;
sim ply I am.” Kahlo, a true otro vert, was far from reclu sive and loved to
hang around with the rich and fa mous (be fore be com ing bedrid den af ter a
ter ri ble trol ley ac ci dent). But there ex isted within her a deep in ner well of
in spi ra tion that was im pen e tra ble to out side in flu ences, in clud ing the pres‐ 
sure to make her self-portraits less “mas cu line”; her silent re bel lion against
these in flu ences was what in spired the ex ag ger ated mono-brow and faint
mus tache that be came the sig na ture of her self-por traits. “I never paint
dreams or night mares,” she wrote. “I paint my own re al ity… and I paint
what ever passes through my head with out any other con sid er a tion.”
Be ing free of the “com mu nal wis dom,” otro verts do not con cern them‐ 
selves with what is achieved through the act of cre ation; it does not have to
be es sen tial so long as it in tro duces some thing orig i nal and not de riv a tive. It
does not even have to be pleas ing so long as it is un prece dented. Be cause
otro verts are al ways fac ing in a dif fer ent di rec tion, they are able to ac cess
new per spec tives to il lu mi nate what is hid den.
6
The Em path
We all know the ex hor ta tion to “put your self in some one else’s shoes.”
It’s a way of en cour ag ing em pa thy for a friend, a col league, a fam ily mem‐ 
ber, or even a stranger go ing through some thing dif fi cult. It is also a nat u ral
ex ten sion of the col lec tive’s bias to ward same ness. It as sumes that once you
can get into those other shoes, you’ll un der stand how that per son feels be‐ 
cause we all feel the same thing in sim i lar cir cum stances. One of the re‐ 
wards of com mu nal life is the feel ing that we can un der stand one an other
through em pa thy. The com mu nal per son trusts that we all love the same
way, hate the same way, fear the same things, and feel the same things. This
is lit er ally sec ond na ture in hu mans to the point where it is the ba sis for one
of the tenets of com mu nal moral ity: Do unto oth ers as you would be done
to.
The power of this state ment, of course, re lies on the as sump tion that we
all want to be treated in the same way. The no tion that we all have the same
needs and de sires is so in grained that we never think to stop and con sider
pe ri od i cally whether it’s re ally true. But when we as sume ev ery one is the
same, we can not ac cess a deeper level of em pa thy be cause we lose the abil‐ 
ity to imag ine what an other per son is go ing through.
That level of em pa thy, which is very hard for com mu nal peo ple to ex er‐ 
cise, comes quite nat u rally to otro verts. They never imag ine what they
would do in your shoes. In stead, they imag ine what you would do; they
look at your cir cum stances the way you your self see them. The abil ity to
dis tin guish an other’s per spec tive from their own also ex plains why otro‐ 
verts tend to be rad i cally non judg men tal. So of ten, a fail ure of em pa thy is
the re sult of some one look ing at a per son’s choices or ac tions and think ing,
“Had I been in that sit u a tion, I would have han dled it bet ter.” Judg ment,
which is re ally in sert ing your own be liefs and val ues be tween you and the
other per son, pre cludes the pos si bil ity of truly see ing things through their
eyes. The otro vert’s abil ity to re spond to a per son’s in ner re al ity with out
judg ment or bias cre ates a high level of em pa thetic in sight.
When com mu nal peo ple find them selves in a group, they au to mat i cally
ex pe ri ence what I call “the Blue tooth phe nom e non”—the abil ity to send
sig nals to and pick up sig nals from any one within a cer tain perime ter. Much
like a Blue tooth de vice, the ma jor ity of hu mans au to mat i cally search for
con nec tion, pair ing with oth ers when pos si ble. Think about all those
strangers in air ports, in gro cery stores, on city streets, who have lit tle trou‐ 
ble be ing to gether. At least un der nor mal, rou tine cir cum stances, no one
con sciously wor ries about any one else in these sit u a tions. Yet ev ery one op‐ 
er ates ac cord ing to the syn chro nized bal let that kicks in to cre ate so cial har‐ 
mony when peo ple are to gether, whether they are strangers or not.
The Blue tooth phe nom e non is what dic tates this chore og ra phy, forg ing a
pas sive con nec tion be tween in di vid ual minds and the lo cal col lec tive ex pe‐ 
ri ence. Ev ery one has a role rel a tive to all the rest. New peo ple are join ing,
and oth ers are leav ing: that the minds are con nected by the same Blue tooth
sig nal makes for smooth so cial in ter min gling. It’s how we know that we are
ex pected to smile and say hello to the neigh bor we en counter in the el e va‐ 
tor, or move our shop ping cart to the side of the aisle so an other shop per
can get by de spite our gen eral inat ten tion to ev ery per son pass ing in front of
our eyes: a nor mal re sponse when we are among a crowd.
The Blue tooth phe nom e non also mit i gates feel ings of alone ness, over‐ 
rid ing the bi nary no tions of “sep a rate” and “to gether.” It tells us when oth‐ 
ers around us are ex cited, or ner vous, or fear ful; it helps us read the vibes.
(A no table ex cep tion to this rule is groups of teenagers, whose sense of
alien ation from peo ple older than them causes dis in ter est and even hos til ity;
as a re sult, they can’t pick up a sig nal from the adults around them, and vice
versa.)
Otro verts, of course, are un able to forge this kind of pas sive con nec tion
with the sur round ing col lec tive. The Blue tooth phe nom e non is what al lows
com mu nal peo ple to ac cess the minds of other peo ple with out much ef fort.
The no tion of feel ing alone, as op posed to be ing alone, is de pen dent not on
the pres ence of other hu mans but on our abil ity to ac cess them (this is why
you con sider your self alone when your neigh bor is on the other side of a
wall—there is no easy ac cess). But otro verts are not wired for group affin ity
in the same way. That the otro vert lacks ac cess to the Blue tooth sig nal
makes prox im ity to a col lec tive of strangers an over whelm ingly lonely ex‐ 
pe ri ence. And the larger the group, the lone lier they feel.
With out di rect ac cess to the “ca coph ony of minds” that com mu nal peo‐ 
ple are able to tap into, otro verts are com pelled to com pen sate by pay ing at‐ 
ten tion to ev ery per son in sight, re gard less how im per sonal, fleet ing, or
anony mous the en counter is. For tu nately for otro verts, that gran u lar level of
at ten tion to each in di vid ual around them is a great as set in one-on-one en‐ 
coun ters. This is where the “be spoke” em pa thy they em body comes from.
When I was a child, I thought that ev ery one could “read other peo ple’s
minds” in the way I did. I would walk to school, mak ing men tal notes about
ev ery one I en coun tered—my un der stand ing of their lives, moods, and sit u a‐ 
tions, all of which I filed away in the ar chives of my brain. I didn’t do it out
of in ter est or fas ci na tion with any par tic u lar in di vid ual—it was sim ply my
in stinc tive re ac tion to en coun ter ing an other per son. I gained noth ing from it
and am not even sure that most of what I con jured up was true, as there was
ob vi ously no way to ver ify my as sump tions. But it was not vol un tary; I
could not turn it off.
Even tu ally, I dis cov ered that while “read ing” ran dom peo ple on the
street is bur den some and fu tile, it was also what al lowed me to forge mean‐ 
ing ful con nec tions in one-on-one en coun ters with peo ple, no mat ter how
brief. My teenage vol un teer job at the hos pi tal, which I men tioned in chap‐ 
ter 4, marked the first time I re al ized this. It was the first chance I had to
com mu ni cate with adults on a deeper level. Some pa tients would strike up a
con ver sa tion with me, and they were so happy to have some one to talk to
that I would of ten re turn to them to con tinue the con ver sa tion af ter I had
fin ished dis pens ing the can dies and pa pers and toi letries. They told me I
helped them feel less lonely, which not only made me feel won der ful but let
me un der stand, for the first time, the power of look ing at the world through
some one else’s eyes, of re frain ing from judg ment, and op er at ing from a
place of pure empa thy.
This was the be gin ning of my life long love af fair with medicine. I was a
fresh man in high school with “vol un teer” em broi dered on my coat and no
idea what ill nesses the pa tients had or what treat ment they were get ting, but
I felt like I was a doc tor be cause I was help ing peo ple feel bet ter, even if
only for a few mo ments. That idea of what it means to be a physi cian has
not changed through out my years of “real” work as a doc tor, help ing peo ple
walk out of my of fice feel ing bet ter than they had when they walked in to
see me.
PART II
A WORLD MADE FOR JOIN ERS
7
We Are All Born Otro verts
Any at tempts to un der stand hu man be hav ior in vari ably stum ble over the
na ture/nur ture dilemma, namely, which as pects of a par tic u lar be hav ior are
in nate and which are learned? We fre quently en counter that du al ity in our
daily lives: If I am eas ily up set, was I born hy per volatile, or has my life ex‐ 
pe ri ence made me more sen si tive to spe cific trig gers? Am I sad be cause of
my cir cum stances, or do I have an in nate ten dency for de pres sion? Why do
I be have this way? Is it me, or is it some thing I learned? Our choices and
ex pe ri ences can be both hard wired (na ture) and ac quired (nur ture), to vary‐ 
ing de grees. We con sider what is hard wired to be im mutable and what is ac‐ 
quired to be po ten tially mod i fi able, even if quite in grained.
Our com mu nal so ci ety has in stilled the be lief that each of us ar rives in
the world with an in nate urge to be long. We are told that this is in part be‐ 
cause, since the dawn of our species, hu man com mu ni ties have been
stitched to gether by the be long ing im pulse. With out it, the co op er a tion-
driven ad van tage would not have been pos si ble. Hu mans, it has long been
be lieved, are hard wired for be long ing be cause for our pre his toric an ces tors,
mem ber ship in a group or tribe in creased an in di vid ual’s chances of sur‐ 
vival.
While there is merit to this the ory, it is only one part of a more nu anced
and com plex story.
The truth is that we all ar rive in the world alone and leave the world
alone. Un like many com mu nal an i mals, hu man new borns re main help less
for so long that fail ing to con nect with or at tach to a care giver greatly de‐ 
creases their chances of sur vival. How ever, most sci en tific con sid er a tions of
the at tach ment im pulse con flate it with the de sire to be long. And while that
ini tial im pulse to at tach is in nate—evo lu tion’s way of en sur ing our affin ity
to par ents and other im por tant providers—any thing be yond it must be
taught.
Chil dren do not nat u rally un der stand or feel at tach ment to a group of
strangers at a young age. As in fants, we don’t know any thing about our cir‐ 
cum stances, no tions of space and time, or what is hap pen ing around us.
With out lan guage, we are dis con nected from the in for ma tion avail able to
the ver bal hu man, and we lack a frame of ref er ence to or ga nize and dif fer‐ 
en ti ate be tween our in ter nal and ex ter nal worlds. There is no clear de mar ca‐ 
tion be tween the self and the other. Ba bies don’t know any thing about the
re la tion ships among the adults sur round ing them, and they cer tainly know
noth ing about the many com plex con cepts that gov ern so cial life. In other
words, they don’t ex hibit any recog ni tion of a group or their place within it.
But each in fant does know them self. Chil dren are born know ing how to
care for them selves by cry ing and fuss ing when they need some thing; how‐ 
ever, at this young age their no tions of so cial be hav ior are rudi men tary, and
they com mu ni cate ba sic needs vaguely and in ef fi ciently.
The first two years of life are spent in this solip sis tic man ner, where
grat i fi ca tions can not be post poned, re gard less of oth ers’ needs; an in fant
does not un der stand, or care, if their mother is busy on a Zoom call at the
time they de mand a feed ing. Then, at about age three, as the ac qui si tion of
lan guage starts to in form their un der stand ing of the needs and opin ions of
oth ers, small chil dren are taught to aban don the self-ab sorbed as pects of
their be hav ior.
Up to this point, need grat i fi ca tion was pro vided on an un con di tional ba‐ 
sis. But now, the child be gins to learn that the ap proval of their care givers
may be con tin gent on the so cial ap pro pri ate ness of their be hav ior.
So cially har mo nious con cepts, such as “share,” “wait your turn,” and
“let the oth ers speak,” are drilled into chil dren, with no ex pla na tion as to
why the child should pre fer the group’s needs over their own. We say, “This
is how you make friends; this is the right way…,” and we re ward chil dren
for com mu nal be hav ior with smiles of en cour age ment, hugs, high fives, and
var i ous other forms of praise. Mean while, at the urg ing of care givers, the
par al lel play that char ac ter izes tod dler hood—when chil dren in the same
space are hap pily oc cu pied with dif fer ent things, obliv i ous to their peers—
is grad u ally re placed by more in ter ac tive forms of play that re quire re‐ 
spond ing to oth ers’ re ac tions and ac tions. No other cog ni tive be hav ioral
con di tion ing oc curs on this uni ver sal a scale.
This well-in ten tioned train ing shapes the en tire up bring ing of most chil‐ 
dren. They are taught to fa vor the needs of the group over their im pulses
and come to un der stand the lim its of their own im por tance rel a tive to that of
oth ers. The grow ing aware ness that they are no longer the cen ter of the uni‐ 
verse is hard for the young child to ac cept, but the re wards for be ing so cial
com pen sate. Thus, the once self-cen tered tod dler is rail roaded into a life of
com mu nal ity.
Most chil dren ab sorb this so cial con di tion ing quite eas ily, al beit with the
oc ca sional bumps along the way. True otro verts are the ex cep tion. Even at a
young age, they sim ply can not sub ju gate their in ner world for the sake of a
shared ex pe ri ence, de spite the ex hor ta tions of care givers, teach ers, and par‐ 
ents. The pro gres sion from unique in di vid ual to so cial an i mal does not un‐ 
fold smoothly for them. In stead, it is met with the kind of mis un der stand ing
and dis ap proval that tends to be levied to ward any one who does not toe the
so cial line. This was cer tainly my ex pe ri ence.
In the 1960s, it was cus tom ary for Is re ali chil dren to join the Scouts
once they reached fifth grade. In many ways, this or ga ni za tion mim icked
the Amer i can ver sion; you met with your peer group twice a week, wore the
ubiq ui tous Boy Scout uni form, and were in structed by the teenage team
lead ers on do ing good deeds and sac ri fic ing your needs for the larger good.
Un like to day, at the time I was join ing, it was con sid ered the “coolest” thing
to do, and any one who did not join was looked upon as “lame” and nerdy.
My par ents bought me the Scout uni form with the match ing scarf and
leather loop to fas ten it around the col lar. I still re mem ber feel ing spe cial
and grown-up as I wore the uni form to the lo cal Scout chap ter. My friends
and I could barely con tain our ex cite ment as we made this rit ual pas sage
from a care free child hood to what felt at the time like our first taste of adult
re spon si bil ity. We all formed a cir cle, sit ting cross-legged on the ground as
the group leader—six teen years old—sat on a small stool and ad dressed us
very se ri ously. When he fin ished talk ing about what it meant to be a ju nior
Scout, he told us to stand at at ten tion as he re cited the pledge, and we re‐ 
peated solemnly af ter him. It went some thing like this:
Be al ways ready.
Be ready to ful fill your duty.
Be faith ful to your coun try and na tion.
Al ways help oth ers self lessly.
Al ways keep your sa cred vow.
As I said the words out loud, I knew for the first time that I was dif fer‐ent. While the other kids seemed awed by the duty be ing be stowed upon
them, I felt only re sis tance. No mat ter how much I tried, I could not share
their en thu si asm. Even though most of the other boys were my good
friends, they sud denly ap peared for eign and far away. For the first time, I
felt deeply lonely; it was as if I were ob serv ing this rit ual from a dis tance,
rather than par tic i pat ing in it.
That night, I told my mother I didn’t want to con tinue with the Scouts.
She told me to give it an other chance, so I went to two more meet ings be‐ 
fore drop ping out, never to re turn. Dur ing the sum mers, all my friends
would go to the wilder ness to learn sur vival tech niques and bond and have
fun with out the adults in ter fer ing. I lived a block away from where the
buses picked them up very early in the morn ing and could hear the kids’ ex‐ 
cited voices ring through the air as they em barked. I en vied them for be ing
so care free and al ways cov ered my head with my pil low to drown out their
voices. I knew from ex pe ri ence that the in stant they left, the brief FOMO
would dis si pate into the great re lief of stay ing be hind, but it was still
painful in the mo ment.
I re mem ber once my mother came into my room as I was ly ing in bed
with the pil low over my head. She could not un der stand why I en vied the
kids for do ing some thing I could have done my self, some thing I and I alone
had cho sen not to do. “Who is stop ping you from go ing on the trip?” she
asked. I could never fig ure out how to ex plain how I felt, and my mother
could not un der stand why I couldn’t be like all the other kids.
I could never ex plain to her why I couldn’t be “nor mal” be cause I didn’t
know my self. I didn’t un der stand why go ing on the kind of trip that most
chil dren only dream of—be ing left un su per vised with a group of peers to
stay up late, pull pranks, and be rowdy—seemed so un bear able to me; I just
knew I wouldn’t be able to en joy it the way most oth ers did.
To day I un der stand why my mother was so con cerned. She wanted me
to par take in com mu nal ac tiv i ties be cause she—like the par ents of my otro‐ 
vert pa tients—felt anx ious about my dis in ter est in what she con sid ered “so‐ 
cial iza tion.” She saw that I loved school and was very friendly and out go ing
when I was in my com fort zone. But she wor ried about my in abil ity to
make my way in com mu ni ties, since to her, and to most peo ple, suc cess in
life is de pen dent on be long ing. Even tu ally, she saw how col lec tive ac tiv i ties
left me drained and un happy. She did not un der stand me, but she loved me
and wanted me to be happy. And so, thank fully, she let me be the otro vert I
was born to be.
8
A Cul ture That Re wards Join ing
We live in a cul ture that puts a pre mium on join ing. Ev i dence of this pri‐ 
or ity be gins very early in life, when we are taught to share, play nicely with
other chil dren, and align our be hav ior with the be hav ior of those around us.
When oth ers form a line, we are di rected to stand in it. When oth ers are
talk ing qui etly, we are told to lower our voices. When oth ers play on the
jun gle gym, we are en cour aged to get out of the sand box and onto the mon‐ 
key bars. Long be fore we are able to un der stand the codes of in ter per sonal
be hav ior fully, we are taught to want to be long and are mo ti vated to quickly
con form to the ex pec ta tions that com mu nal life re quires.
Mean while, we are pre sented with end less op por tu ni ties to forge af fil i a‐ 
tions with our peers: car pools, sum mer camps, team sports, af ter-school
clubs, and so forth. Class rooms are of ten seg mented into teams or co horts,
each as signed la bels to re in force group iden tity and be long ing (e.g., red and
blue teams). The abil ity to as sim i late into these groups is seen as a pre req ui‐ 
site for healthy so cial and emo tional de vel op ment, and opt ing out is rarely
an op tion.
The mo ti va tion to “fit in” ramps up in early ado les cence, which is when
we dis cover (of ten the hard way) that dis re gard for the group leads to un‐ 
hap pi ness and re jec tion, whereas con form ity con fers so cial re wards. The
de sire for pop u lar ity and so cial ap proval be comes all-en com pass ing, just as
the cri te ria for in clu sion into peer groups be come stricter and pop u lar
cliques close ranks.
This “guided join ing” ta pers off af ter age twenty or so, when groups cre‐ 
ated for us by adults (classes, af ter-school pro grams, camp, fam ily, etc.) be‐ 
gin to lose ex ter nally im posed struc ture. With time, our grow ing ca pac ity
for ab stract think ing al lows us to join no tional groups based on shared con‐ 
cepts and ideas, like po lit i cal par ties, re li gions, or other ide olo gies. This
leap is the fi nal step into full-fledged be long ing.
By this point, we have learned the un am bigu ous les son that in adult‐ 
hood, you can not ex pect groups to form or gan i cally, the way they did in
your high school home room or your col lege dor mi tory. In stead, you have to
iden tify po ten tial groups and make an ef fort to join them, or even take part
in their cre ation.
Sim i larly, the so cial rank ing sys tem changes. In child hood and ado les‐ 
cence, the group un of fi cially (and un fairly) as signs a par tic u lar so cial rank‐ 
ing to each one of the mem bers based on the same at tributes that gov ern all
mam mals’ rank ings: looks, health, and size. Those mech a nisms change in
adult hood. Good looks con tinue to be an as set, but the so cial rank ing of
adults is also based on in tan gi ble sta tus mark ers such as money, class, na‐ 
tion al ity, and other neb u lous “qual i ties.” Ex clu siv ity also plays a role: the
harder the ad mis sion to the group—such as coun try clubs or alumni as so ci‐ 
a tions of elite uni ver si ties—the more de sir able it be comes.
Most com mu nal peo ple spend an in or di nate amount of time on “friend‐ 
ship main te nance,” gain ing ad mis sion to and keep ing up with the myr iad
groups they are a part of, spend ing time, money, and ef fort to be ac cepted,
even where they are un wanted, and to “re main rel e vant“ in the way they’ve
al ways been taught mat ters.
On one hand, this evo lu tion makes join ing more dif fi cult and re quires a
higher mo ti va tion level than ready-made child hood groups. On the other
hand, it makes re jec tion harder to swal low. Com mu nal peo ple who are so‐ 
cially un suc cess ful de velop anx i ety, self-es teem is sues, and other men tal
health chal lenges be cause they have learned to equate their pop u lar ity with
their sense of self.
As so cial life be comes in creas ingly self-scripted, the need to be long be‐ 
comes more ur gent. For many com mu nal in di vid u als, be long ing to a group
—whether it’s the for mal va ri ety, like a re li gious con gre ga tion, or in for mal,
like a cir cle of friends—pro vides the so cial sup port needed to ward off dis‐ 
com fort with the fu til ity of life we all en counter at mo ments in adult hood,
along with the grow ing aware ness of the lone li ness of death.
For a so ci ety, com mu nal ity can be es pe cially valu able in the face of
shared hard ship, when any group tends to close ranks in grim de ter mi na‐ 
tion. A calamity like a nat u ral dis as ter, war, or ter ror is a threat to col lec tive
safety, and its ar rival means in di vid u als are of ten will ing to make great sac‐ 
ri fices, and some times even risk their own lives, in or der to save oth ers, in‐ 
clud ing strangers. This level of al tru ism is rare in ev ery day life, be cause the
ma jor ity of the time, get ting along does not ne ces si tate great sac ri fice.
Greed, in equal ity, com pe ti tion—all things that the col lec tive tol er ates and
even ven er ates in times of plenty—be come un sus tain able in times of cri sis.
In stead, help ing oth ers and shar ing bur dens rather than fo cus ing on one self
sud denly be come ad mirableand even heroic, bring ing the so cial re wards
that fi nan cial suc cess and elite sta tus bring in reg u lar times. The higher the
ex is ten tial threat to the group, the greater the feel ing of unity, as well as the
level of sac ri fice, as the group calls upon each mem ber to do their part for
the col lec tive sur vival.
The COVID pan demic demon strated this prin ci ple many times over.
When it ar rived, self-im posed re stric tions of an un prece dented na ture
sprang up overnight. Busi nesses shut their doors, schools sent chil dren
home, and whole coun tries went into vol un tary quar an tine in an at tempt to
stop the spread of the virus. Peo ple kept six feet of dis tance from one an‐ 
other, stopped meet ing in in door spa ces, and wore masks in pub lic: both to
pro tect them selves and out of con sid er a tion for oth ers. Mean while, char i ta‐ 
ble do na tions and other forms of as sis tance such as food de liv ery to the el‐ 
derly and home bound and tele phone helplines serv ing the so cially iso lated
in creased dra mat i cally, demon strat ing the col lec tive to in deed be stronger
than the sum of its parts.
All of which re in forces the one cen tral, im mutable cul tural prin ci ple in
any so ci ety at any time in his tory: To geth er ness is prefer able to alone ness.
And while this is true for many peo ple, par tic u larly dur ing dif fi cult times, it
is not true for otro verts, who never feel true unity with the groups to which
they are as signed even while band ing to gether with oth ers to en sure the
mem bers’ mu tual sur vival.
Our cul ture puts so much stock in com mu nal ity that a dif fer ent stance—
the otro vert stance—is un der stood as pathol ogy. If we all agree there is only
one right way to move through the world, the otro verts’ can only be the
wrong way. For tu nately, the vast ma jor ity of peo ple would dis agree with
that state ment. We do not ex pect all peo ple to be the same. In fact, we ac‐ 
cept a wide va ri ety of per son al i ties and tem per a ments—and of ten en joy
them. Non-be long ing is merely an other facet of one’s per son al ity that
shapes cer tain ex pe ri ences of be ing hu man. And yet we treat it very dif fer‐ 
ently from other pref er ences by con tin u ing to in sist that otro verts give up
their true self in fa vor of the col lec tive (per haps be cause so many of us did
un dergo the forced aban don ment of our own in nate solip sism in ex change
for so cial ac cep tance).
The pres sure put on otro verts to con form is of ten ex haust ing and frus‐ 
trat ing to both sides, but there is one thing it never is: ef fec tive. In deed, I
have many pa tients who come to me as adults still won der ing why they
can’t make peace with the pres sure their fam i lies and so ci ety at large put on
them to go along with the ex pected norms.
My pa tient T was one such case. When we first started meet ing vir tu ally,
she was emo tion ally par a lyzed, be sieged by in tense anx i ety that made ev‐ 
ery thing feel im pos si ble. She was on nu mer ous psy chi atric drugs, to no
avail, and had been bedrid den for two years. When she Zoomed with me
from bed, ap pear ing di sheveled and dis traught, she shook with emo tion.
She told me that she had al ways been her fam ily’s “black sheep” be cause
she could never do any thing right. She came from a very wealthy, snob bish
fam ily made up of du ti ful peo ple who had all fol lowed the same so cial rules
for gen er a tions. Within the fam ily, there were un am bigu ous rules about how
a per son should con duct their life: be re served and never showy; have good
man ners; have the right kind of week end house in the right place; and, if
you were a man, work in one of a small num ber of ap proved pro fes sions.
Women were to fo cus on lunch ing, which was taken as se ri ously as though
it were a pro fes sion.
T was the an tithe sis of all of this. From an early age, she had felt meek,
dif fi dent, and un com fort able in her skin. She felt like her life was one long,
in ex orable exam, which she failed re peat edly. She un der stood that there was
a cer tain “cor rect” way to live: a code to life that was known to oth ers but
that she sim ply couldn’t fig ure out. She fur ther thought that ev ery one
around her, hav ing cracked the code, was able to move eas ily and un err‐ 
ingly through life while she was al ways at risk of mak ing mis takes. Her
fam ily’s rigid ity about what was deemed ap pro pri ate be hav ior made her
feel that her mere pres ence in ter fered with the oth ers’ sense of har mony.
Worse, she had grown to in ter nal ize the oth ers’ dis ap proval of her dif fi cul‐ 
ties. She con sid ered her self lazy and in dul gent, self-ab sorbed and en ti tled,
echo ing all the crit i cism di rected at her re fusal to en gage in the pageantry of
com mu nal life.
Over the years, T had been di ag nosed with the en tire gamut of mood and
per son al ity dis or ders. She’d been pre scribed med i ca tions, mag netic stim u la‐ 
tion of the brain, spe cial di ets, be hav ioral treat ment, di alec ti cal be hav ior
ther apy—a huge as sort ment of treat ments that had only one thing in com‐ 
mon: they did not work. She was sent to re hab pro grams—de spite the fact
that she did not drink al co hol and never did drugs. She ad hered du ti fully to
ev ery treat ment sug ges tion, no mat ter how far-fetched, as she wanted des‐ 
per ately to feel bet ter. But in a way, this only con trib uted to her mis ery, as
her lack of progress was blamed en tirely on her: “She is not try ing enough”
and “She does not want to get bet ter.” All of which only am pli fied her anx i‐ 
ety and left her with an in creas ing sense of be ing mis aligned with the world
around her, mak ing it very hard to func tion.
She doubted ev ery thought or feel ing she had and was par a lyzed by fear
of cer tain fail ure. She’d tried to have a ca reer, earn ing an MBA and a job in
real es tate in vest ment, but felt pro foundly dis con nected from the groups of
stu dents and col leagues she en coun tered. Even tu ally, she left that po si tion
and started iso lat ing her self for longer stretches. At a cer tain point, even
meet ing a neigh bor in the hall way be came too much for her. She re treated
into her apart ment and, other than ther apy—of which she’d had a lot—had
lit tle con tact with the out side world. Her doc tors con cluded that she was
“afraid of life.” Sadly, the last as sump tion was ac tu ally the first ac cu rate
one. But since it came at the end of long ther a peu tic ef forts, it was stated as
a ver dict rather than a di ag no sis—an ad mis sion of fail ure in treat ing her
rather than a di rec tion for fu ture treat ment.
But she never lost the mo ti va tion to find a way through. I’d been rec om‐ 
mended as a psy chi a trist who could help peo ple con sid ered re sis tant to
treat ment, and at first, she be lieved in me just as she had be lieved in ev ery
doc tor who came be fore me, which is to say, not very much. She knew that
at the deep est level, none of them truly un der stood her, but she also couldn’t
help but chas tise her self for be ing mis un der stood. She told me, “I am not
good at any thing. I am a freak.” To which I replied, “You are very good at
one thing—namely, stay ing in bed.” Her re sponse? “Doc tor, re verse psy‐ 
chol ogy has been tried plenty. It does not work on me: my en tire psy chol‐ 
ogy is al ready re versed.”
I told her that I meant it se ri ously. She’d been telling her self she could
not do any thing, but she was ac tu ally very good at stay ing in bed. It was not
good for her, but she was un de ni ably com mit ted to it. Most peo ple can not
stay in bed for long, un in ter rupted pe ri ods. “It’s help ful,” I ex plained, “to
find at least one thing that you are good at or at least con sis tent in. Stay ing
in bed is your su per power.”
She thought about it, and a lit tle smile crept onto her face be fore she
said, “I am a stay ing-in-bed spe cial ist… the best!”
“Yes,”I said. “You’ve per fected it into an art form.”
This was the first small step in what even tu ally be came a new life for T.
Over many months and many con ver sa tions, she started re al iz ing that stay‐ 
ing in bed to avoid life had not suc ceeded in eas ing her suf fer ing. This
opened her up to the no tion that her sense of non-be long ing was ac tu ally the
cause rather than the out come of her life long strug gles and that she would
never be at peace un til she learned to un der stand and ac cept this as pect of
who she was. At one point, I asked her if she could think of an en vi ron ment
(other than her bed) that made her happy. She replied that the best time of
her life was when she had trav eled alone to the South Pa cific is lands and
spent her days scuba div ing and swim ming in the sea.
When I sug gested that per haps it was not the best choice to con tinue liv‐ 
ing “land locked” in the north east of the coun try, she in sisted that her mis ery
was within her and there fore fol lowed her ev ery where. No mat ter where she
went, she claimed, she could never break free from the idea that ev ery one
around her was judg ing and crit i ciz ing her. I dis agreed.
All otro verts have an in ter nal re bel lious streak—a kind of shield against
in doc tri na tion—which al lows them to live as their true selves even in the
face of so ci etal pres sure. But for those like T, whose re bel lious streak had
been crushed by a strict, un com pro mis ing fam ily, the in abil ity to be in doc‐ 
tri nated makes life even more dif fi cult. It is akin to the ex pe ri ence of some‐ 
one born into a very re li gious fam ily and com mu nity who se cretly can not
be lieve in a god. No mat ter how hard they try, it does not hap pen. They can
pray and go through the re li gious mo tions, but in side they feel like frauds. T
thought that be ing an out sider de spite hav ing no per ceiv able “so cial faults”
had to be the prod uct of some per sonal fail ing that she needed to find a way
to over come. To her fam ily, her de ci sion not to get mar ried or have chil dren
and her de sire to live on a South Pa cific is land seemed capri cious, im pul‐ 
sive, or just ev i dence of her will ful re sis tance to the no tion of liv ing the life
they ex pected. She had be come con vinced that she was too dam aged to ever
be able to mas ter the rules of so cial en gage ment, which even tu ally grew so
over whelm ing that she dropped out al to gether.
We spent the next year or so con sid er ing the pos si bil ity that even though
a group of peo ple—in this case, her fam ily—agrees on a cer tain way of be‐ 
ing and be hav ing, it isn’t nec es sar ily the only way. She came to un der stand
that what ever her close cir cle might have ex pected of her, she was in no
way com pelled to com ply—that she was al lowed to have her own point of
view even if the rest saw things dif fer ently, and that her oth er ness was nei‐ 
ther a men tal dis or der not a moral fail ing: it was sim ply part of her nat u ral
wiring.
Otro verts like T find many ba sic tenets of com mu nal life dif fi cult and
even baf fling. These may in clude the com monly held no tion that cel e bra‐ 
tions must nec es sar ily in volve gath er ing many peo ple to gether in pub lic,
that the ma jor ity is usu ally right, that team work is im por tant for progress,
that it’s more im por tant to be pop u lar than it is to be au then tic, and that
long-held, shared be liefs and tra di tions about the “right” way to be have and
move through life are uni ver sally valu able.
This chronic ten sion be tween what the world be lieves and what the otro‐ 
vert knows to be true is part of the rea son why otro verts tend to present with
a com plex of seem ingly un re lated dif fi cul ties—in T’s case, iso la tion, de‐ 
pres sion, and lack of mo ti va tion to en gage in life, along with a host of non‐ 
spe cific so matic com plaints in clud ing nau sea, back pain, and in ter mit tently
se vere ab dom i nal cramps. Since none of these could be ex plained by any
ob jec tive find ing, she was in stead di ag nosed with a so matic dis or der—
mean ing she was also (ac cord ing to her doc tors) in vent ing phys i cal ail‐ 
ments. In deed, the sum of her symp toms pre sented an ir re sistible temp ta tion
for her clin i cians to la bel her suf fer ing a psy chi atric dis or der.
Her doc tor had con cluded that she was “afraid of life,” yet had any of
them taken the time to ex plore the na ture of those fears, they would have
dis cov ered that what T was ac tu ally afraid of was com mu nal life. In par tic u‐ 
lar, she feared be ing made to feel like there was some thing wrong with her
ev ery time she di verged from the rules about what was deemed so cially ac‐ 
cept able.
To be clear, the fact that one is an otro vert does not nec es sar ily mean
that one isn’t also suf fer ing from a psy chi atric dis or der or ex pe ri enc ing
some other men tal health chal lenge. But in the vast ma jor ity of cases, the
sense of non-be long ing is the com mon thread in all their dif fi cul ties. Once
otro ver sion is iden ti fied, ev ery thing rapidly be comes clear. In deed, once we
de ter mined that T was an otro vert, we shifted to a new ap proach. The main
fo cus of all past ef forts had been get ting her to be a nor ma tive mem ber of
the com mu nity, a com mon if mis guided goal when work ing with otro verts.
In fact, most psy cho log i cal treat ments for a wide range of prob lems aim to
in crease per sonal com fort with one self and one’s en vi ron ment. In com mu‐ 
nal peo ple, these two ob jec tives are usu ally har mo nious, and even syn er gis‐ 
tic: feel ing more com fort able with them self helps the com mu nal per son feel
more com fort able in their en vi ron ment, and vice versa. In otro verts, how‐ 
ever, the two spheres are of ten un syn chro nized; the more com fort able an
otro vert is with their in ner self, the less com fort able they are in their so cial
en vi ron ment. Be cause the otro vert will never feel truly com fort able in a so‐ 
cial world de signed for join ers, the goal is to ad dress their per sonal emo‐ 
tional com fort rather than try to “so cial ize” them.
When I sug gested that T take a trip to an is land with the right color of
sand and wa ter, her old fear, ex pressed to me a year ear lier, reared its head
again. “I will only prove to my self that I am un happy ev ery where I go,” she
said. I was also con cerned about that pos si bil ity, but I knew she needed to
do some thing to break the paral y sis she was cur rently ex pe ri enc ing, and
where bet ter than a place and a set ting where she al ready knew she felt
com fort able? She was no longer on speak ing terms with her fam ily by that
point, so there was no col lec tive from which she had to fear judg ment, and
no pres sure to jus tify her plan. In that sense, she was free to do as she chose
in a way many peo ple are not.
The de ci sion was made. As so of ten hap pens in psy chi atric treat ment,
most of the work had al ready hap pened be fore hand, in T’s un con scious
mind. This al lowed her to go from ly ing in bed one day to get ting on a
plane to the Car ib bean (closer than the South Pa cific, with the same calm‐ 
ing ef fect) the next. The mo ment for ac tion had ar rived, and she had taken
it. She rented a place for a month and ended up stay ing six. Then T came
back to the United States, sold her apart ment, and moved to that is land.
Ob vi ously, I present here the nut shell ver sion of the treat ment. The
longer ver sion is more com pli cated, and fraught with ups and downs, all of
which led to her even tual re al iza tion that while no one among her fam ily or
friends ap proved of her find ing her call ing as a div ing in struc tor on a Car ib‐ 
bean is land, that didn’t make her choice in valid. She dis cov ered a life that
could make her happy, and that was enough.
Otro verts share likes and dis likes with all peo ple—some like the beach
and some like the moun tains, soto speak. It’s in the realm of com mu nal
likes and dis likes where the di ver gence can be vast, as T ex pe ri enced. Be‐ 
ing un able to join (or gen uinely par take in) what oth ers vis i bly en joy makes
some one like T ques tion their judg ment, which can trig ger over whelm ing
self-doubt or even paral y sis, as it did for her. In a so ci ety gov erned by a set
of col lec tive rules and norms dic tat ing the “right” way to live, it can be very
hard to en ter tain the idea that per haps you and the group are both “right.”
Of course, there is no one way to live and act and be, and the otro vert way
is just an other way, rather than the wrong way.
For an otro vert, ac cept ing what we think of as the clichéd state ment “It’s
okay to be you” is ac tu ally a mon u men tal shift. So many of us otro verts
have, like T, lived our whole lives with the ex pe ri ence of be ing mis un der‐ 
stood, and of ten judged by the group. When otro verts fi nally reach a place
of un der stand ing that there is noth ing wrong with who they are, it is cathar‐ 
tic in a truly pro found way.
With the re al iza tion that you don’t need to force your self to be some one
you are not in or der to be happy, otro verts can give them selves per mis sion
to opt out of things that cause dis com fort and, in do ing so, al low their au‐ 
then tic selves to thrive. They learn to con nect even more pow er fully with
in di vid u als, en joy ing even deeper and more lov ing re la tion ships with peo‐ 
ple they feel close to. They learn that while the world may be pri mar ily de‐ 
signed for join ers, join ing isn’t ac tu ally manda tory for hap pi ness.
9
The Fal lacy of Fit ting In
Think of a very sim ple crea ture, an amoeba, for ex am ple. It lives in the
same world as we do but has a dif fer ent ex pe ri ence. De void of any spe cial‐ 
ized sen sory struc tures or brain, this uni cel lu lar or gan ism lives a very sim‐ 
ple life. It has no re la tion ship or kin ship to any other crea ture. It has no fear
of the fu ture or mem o ries of the past. It just ex ists, and af ter a while, it ei‐ 
ther dies or is di vided into two new amoe bas. Even non hu man pri mates,
which have large brains and live in com plex so ci eties, un der stand their so‐ 
cial worlds through un con scious, in stinc tive means. Though they do forge
so cial group ings and hi er ar chies, they dif fer en ti ate be tween “us” and “not
us” based on sur face char ac ter is tics such as how an other an i mal smells,
looks, or sounds, rather than re ly ing on ab stract con cepts to gov ern so cial
life.
Hu mans, on the other hand, can make so phis ti cated as sump tions about
the work ings of the so cial uni verse, in clud ing where and how we fit into it.
Our ad van tage is re lated to the fact that we pos sess cer tain men tal fac ul ties
that are dis tinct from those of all other an i mals, broadly de fined as con‐ 
scious ness. Our con scious ness frees us from re liance on ba sic in stincts and
al lows us to form groups on the ba sis of cho sen pref er ences, val ues, or ide‐ 
olo gies rather than the shared phys i cal char ac ter is tics other pri mates use to
de ter mine whether an other is “one of us.” Our con scious ness al lows us to
act and plan in ways that go be yond the in stinc tual; we may still act on in‐ 
stinct, but with the aware ness that we are do ing so. This lends us the ca pac‐ 
ity for highly ad vanced be hav ioral adapt abil ity: in other words, the abil ity
to mod u late our be hav ior in or der to “fit in” with ev ery one around us.
Con scious ness then com bines with lan guage to en able co op er a tion, col‐ 
lab o ra tion, and the trans mis sion of so phis ti cated and de tailed in for ma tion
across large groups.
Since we can never truly know how an other per son will be have at any
mo ment, we have de vel oped com plex and so phis ti cated ways of sur viv ing
to gether de spite hav ing in di vid ual minds and needs. For ex am ple, the many,
of ten con flict ing, in di vid ual choices we each make when in ter act ing in so ci‐ 
ety could, in the ory, cause dis cor dant be hav iors and fric tion. Hu man con‐ 
scious ness sup plies us with shared norms and prin ci ples that in form how we
must be have in or der to pre serve har mony in any given so cial in ter ac tion. In
or der to par take in the so cial flow of life, we have to learn those or ga niz ing
prin ci ples and in cor po rate them into our ev ery day rou tines, which is the
func tion of so cial iza tion.
In a group, mu tual ad her ence to these or ga niz ing prin ci ples, or stan dards
of be hav ior, re duces fric tion and pro vides us with a sense of to geth er ness.
But these stan dards also serve an other, equally im por tant func tion: or ga niz‐ 
ing prin ci ples al low us to process a vast num ber of be hav ioral choices at
any given mo ment, while also en sur ing a cer tain de gree of pre dictabil ity in
our ex pe ri ences with our fel low hu mans. To give a triv ial ex am ple, when
some one asks us for a glass of wa ter, we can re act in any one of many pos‐ 
si ble ways: we can walk away, throw the wa ter in their face, or tell them
we’d rather not. This ex am ple may seem ab surd, but with out clear rules
about what con sti tutes ap pro pri ate be hav ior, con sider the amount of in for‐ 
ma tion we would need to process in or der to ar rive at the ex pected re sult:
giv ing the thirsty in di vid ual a glass of wa ter.
These or ga niz ing prin ci ples can be ei ther uni ver sal, or lo cal.
Uni ver sal or ga niz ing prin ci ples are shared among all hu mans re gard‐ 
less of group mem ber ship or cul ture. We ex er cise re straint of im pulses, we
speak at a par tic u lar vol ume, we use rec og niz able fa cial ex pres sions, and so
forth. Those uni ver sal cues ap ply to ev ery one equally, and the as sump tion
that ev ery one will abide by them pro vides us with a cer tain level of pre‐ 
dictabil ity even in sit u a tions that are very dif fer ent from those we are ac cus‐ 
tomed to; it’s how we can be rel a tively cer tain that we will not get wa ter
thrown in our face by a per son who is un fa mil iar to us. So cial ac cep tance is
con di tioned on ad her ence to uni ver sal or ga niz ing rules; hence, chil dren are
ex pected to ac quire the ba sics rel a tively quickly so as to not be shunned by
their co hort.
Lo cal or ga niz ing prin ci ples are the par tic u lar cus toms shared among
dis crete groups of peo ple. Whether a group co heres around na tion al ity, vo‐ 
ca tion, so cial class, race, re li gion, hob bies, pol i tics, or any other shared
iden tity, that group is gov erned by spe cific un writ ten or even writ ten rules.
How ever, mem ber ship in these groups is quite fluid; the same in di vid ual of‐ 
ten moves in and out of var i ous cir cles and, in do ing so, mod i fies their be‐ 
hav ior ac cord ing to the pre vail ing lo cal prin ci ples (what a so ci ol o gist might
re fer to as “code switch ing”). When join ing a new group, we need to learn
these lo cal prin ci ples quickly, even as the uni ver sal ones re main gen er ally
the same re gard less of where we find our selves.
With out or ga niz ing prin ci ples, each of us would face a del uge of choices
in each and ev ery so cial in ter ac tion. We would have to in vest an in or di nate
amount of emo tional en ergy to imag ine what oth ers think about our be hav‐ 
ior and about us to “make sure” that we are so cially okay. All our de ci sions
and in ter ac tions would be en veloped in par a lyz ing doubt.
The otro vert is gen er ally aware of uni ver sal or ga niz ing prin ci ples but of‐ 
ten strug gles to com pre hend lo cal ones, which can present chal lenges, the
ma jor one be ing that ir re spec tive of how fa mil iar or rou tine a sit u a tion is—
say, walk ing to work in the morn ing, go ing to the neigh bor hood mar ket, and
even walk ing leisurely on the prom e nade or in the park—the pres ence of a
group, even a fa mil iar group, ren ders its rules un fa miliar to the otro vert. It
gets even worse for otro verts when there is also a need for co or di na tion,
such as wait ing in line, en ter ing and leav ing a busy de part ment store, or
weav ing one’s way through the crowds. I some times think of it like per‐ 
form ing with a dance troupe with out know ing the chore og ra phy—a sit u a‐ 
tion in which one can only look anx iously at the other mem bers and try to
mimic their move ments.
These or ga niz ing prin ci ples al low most peo ple to prac tice “nor mal” be‐ 
hav ior with out ap par ent dif fi cul ties. But what does “nor mal” mean? Sur‐ 
pris ingly, there is no con sen sus re gard ing what it takes to be con sid ered
nor mal, which is prob lem atic for any one who thinks dif fer ently. There is no
clear psy chi atric def i ni tion of “nor mal,” which leaves it up to the col lec tive
to de cide what and who is “ab nor mal.”
The best def i ni tion of “nor mal” that I’ve en coun tered is be ing pre‐ 
dictable to oth ers. For the so cial con tract to suc ceed, ev ery mem ber of the
col lec tive needs to meet a “thresh old trust” with all the rest. And we as sess
trust by de grees of pre dictabil ity. Pre dictabil ity is gen er ally benev o lent and
help ful; it is meant to ease so cial in te gra tion and man age the ten sion that
can arise in a group of min gling strangers. Even though oth ers can not read
our thoughts or fore see our in ten tions, we do our best to re as sure them of
our good in ten tions by be hav ing in a way they ex pect.
That is true for most in ter per sonal en gage ment in ev ery day life. The
abil ity to re li ably pre dict oth ers’ be hav ior en ables us to go about our daily
rou tines, over the course of which we must trust to tal strangers with our
lives: pi lots, con struc tion en gi neers, physi cians, driv ers at a cross walk, and
so forth. Ev ery time we con sume food or drink made by an other, we en gage
in an act of ex treme trust. We un ques tion ably as sume—with ab so lutely no
ev i dence to sup port this as sump tion—that no one has poi soned it (and in‐ 
deed, this trust is war ranted in most in stances; in its ab sence we would de‐ 
scend into para noia).
Be long ing is pred i cated on ad her ing to this sanc tioned be hav ioral reper‐ 
toire, which is why com mu nal peo ple are viewed as pre dictable and trust‐ 
wor thy, whereas otro verts can be met with sus pi cion and even fear. It makes
peo ple un com fort able when they don’t know what a non-be longer is think‐ 
ing or what the non-be longer will do next (al though ob vi ously, it is not
com monly pos si ble to know what oth ers are think ing or would do next).
Those who can not ad here to the so cial script de cided by the ma jor ity can not
count on the trust of oth ers.
This is the plight of otro verts: they are pe nal ized for be ing un able to
aban don their deep est selves for com mu nal pur poses. The power of com‐ 
mu nal sug ges tion re quires that ev ery one go along with it. This means that
any one who sees re al ity as an in di vid ual ex pe ri ence may dis rupt the shared
per cep tion of the rest, which is threat en ing to the com mu nal or der. Otro‐ 
verts are made to feel weird and wrong for pre fer ring soli tude over so cial iz‐ 
ing. They re al ize they will al ways be mis un der stood, and even mis trusted,
so they spend sig nif i cant time work ing to cre ate an il lu sion of be long ing by
abid ing by group deco rum. But fol low ing these so cial scripts can make rou‐ 
tine en coun ters with peers mad den ing—and very ex haust ing.
These so cial pres sures to ap pear “nor mal” and non threat en ing can com‐ 
bine to re sult in otro verts’ real frus tra tion about the need to con stantly mask
their real ten den cies. Otro verts will do their best to fol low the rules and ap‐ 
pear pre dictable, but they can sus tain this pre tense for only so long. Be‐ 
cause they be come very good at hid ing their dis taste for com mu nal events,
they are of ten sub jected to well-mean ing peer pres sure from those who gen‐ 
uinely de sire their com pan ion ship or who would feel sorry for them if they
“missed out” on all the fun. But other times, what might ap pear like the de‐ 
sire to spend time with them and/or spare them from FOMO is ac tu ally an
un con scious at tempt to val i date the group. Since otro verts are non con‐ 
fronta tional and con flict averse, they of ten cave quite eas ily to such peer
pres sure. But go ing against our in stincts will al most al ways back fire. One
otro vert I know told me a story of be ing guilted into at tend ing her twen ti eth
high school re union by a friend who didn’t want to go alone. She ac qui‐ 
esced, but about an hour into the party she had be come so bored by all the
small talk that she ended up leav ing, slip ping qui etly out the back door in
the hope that no one would no tice. This dis ap pear ing act, she said in ret ro‐ 
spect, “made me feel guiltier than I would have felt if I had re fused to go in
the first place.”
This feel ing of obli ga tion is one I of ten en counter in my otro vert pa‐ 
tients. One of them, J, felt highly over whelmed. Com ing from a warm, large
ex tended fam ily, he com plained that ev ery minute of his life was given to
so cial obli ga tions. At tend ing end less fam ily events of ten left him ask ing
him self, “What am I do ing here?” On many oc ca sions, what ever was be ing
cel e brated held lit tle to no mean ing for him. As he de scribed one of these
times, “I barely know the bride groom; he is my sec ond cousin on the West
Coast. And yet, I had to fly to San Diego, spend the week end in a crummy
ho tel, and des per ately try to find some thing to talk about with other guests I
had never met be fore. I hate those events.”
To J, these kinds of oc ca sions felt like en tirely nec es sary du ties (not to
men tion a to tal waste of a week end). So to gether, we be gan to look at what
turned out to be two sets of obli ga tions: nec es sary ones and un nec es sary
ones. Nec es sary obli ga tions are the things we do not want to do but have to
for the sake of our ca reers or fam i lies, such as the less in ter est ing or in spir‐ 
ing parts of a job, or at tend ing a child’s per for mance. Un nec es sary obli ga‐ 
tions are things that we nei ther want nor have to do but do any way be cause
we feel so cially pres sured, such as at tend ing mul ti day wed ding week ends or
happy hour with col leagues. When we looked deeper we found out that
many of the obli ga tions J found so drain ing, like that sec ond cousin’s wed‐ 
ding, were un nec es sary. He met them be grudg ingly, be liev ing that it was his
duty as a fam ily mem ber and that oth ers would judge his ab sence harshly.
Af ter we worked through these fears to gether, J re al ized he must choose
his leisure com mit ments ac cord ing to his own needs. It is ac tu ally that sim‐ 
ple. Ac cept ing in vi ta tions that we deem nec es sary for one rea son or an other
is un avoid able. But there is no rea son to do some thing solely be cause it is
the so cially dic tated “thing to do.” You get no ac co lades for at tend ing. And
the worst that can hap pen when you don’t at tend is prob a bly some peo ple
mut ter ing about your “aso cial ity,” but those who mut ter are pre cisely the
ones you did not want to spend time with in the first place.
Com mu nal events were made for com mu nal peo ple. Many ac tu ally en‐ 
joy them, or at least find them tol er a ble. But this is not the case for otro‐ 
verts, for whom par tic i pat ing in com mu nal leisure ac tiv i ties—like tak ing an
ex er cise class, at tend ing a col lege re union, or go ing on a cruise—is a kind
of tor ture be cause they can not tune out in di vid u als in fa vor of the group.
Events or ac tiv i ties that re quire them to fol low a strict set of rules—like tak‐ 
ing a Pelo ton class, join ing a work task force or com mit tee, or at tend ing re‐ 
li gious ser vices—are even worse.
Af ter years of forc ing my self to at tend so cialevents, I re al ized that the
ef fort in vari ably out weighed what ever plea sure I might have de rived from
the oc ca sion. Yet, I some times be grudg ingly go to obli ga tions I can not
avoid, mostly re gard ing my chil dren. Once, I had to at tend a meet-and-greet
re cep tion with par ents at my daugh ter’s school for the start of a new year, as
my wife, who nor mally at tends such events, was abroad, and I felt I must
show up for my daugh ter.
First, all the par ents were cor ralled into an au di to rium for a talk by the
prin ci pal and the teach ers. Ev ery one was per fectly pleas ant, but I felt un‐ 
com fort able in the midst of a group that felt kin ship purely be cause they
had chil dren at the same school in the same grade. We were or ga nized
around a su per fi cial, and in many ways ar ti fi cial, bond that made no sense
to me. At the re cep tion that fol lowed, this shared ex pe ri ence made peo ple
ea ger to con nect, which, aided by a re quired name tag, made me prey to un‐ 
fet tered small talk. It was one of those oc ca sions when I felt I wanted to dis‐ 
ap pear—and that’s what I did. I went to a far away bath room where I was
un likely to meet any one and tried to calm down. Then I started feel ing
guilty that I was some how dam ag ing my daugh ter’s suc cess by be ing so
child ish and strange. So I re turned to the party, where two or three par ents
stand ing out side the door way beamed at me, want ing to “con nect.” Af ter a
few min utes, I mut tered some ex cuses and made a bee line back to the bath‐ 
room. Now I was livid with my self. Why could I not be like all the other
par ents? I ran back and forth the en tire evening, dodg ing par ents, break ing
away, and be ing drawn back. Even tu ally the evening ended, and I re turned
home ex hausted and drained. Would it have been bet ter not to have gone?
Prob a bly.
As a non joiner, your first duty is to your self, and it is en tirely pos si ble to
ex cuse your self po litely, per haps even by telling a white lie if nec es sary.
When J de cided to fol low his pref er ences in the way we had dis cussed, he
im me di ately saw a huge im prove ment in his life, and no real dif fer ence for
any one else. Peo ple who liked him con tin ued to like him and peo ple who
didn’t like him con tin ued to not like him. As for the rest, who didn’t care
one way or the other, well, they con tin ued not to care. And a lot of the time,
peo ple barely even no ticed. Be cause otro verts are so hy per aware of other
in di vid u als, we of ten as sume that other peo ple are the same way. But in re‐ 
al ity, com mu nal peo ple are much more fo cused on the group than they are
on the pres ence or ab sence of any in di vid ual mem ber. In the vast ma jor ity
of cases, the be lief that there is some price to pay for stray ing from un nec‐ 
es sary so cial en gage ments is all in our heads.
J is far from my only pa tient who has tried what he did. And no one suf‐ 
fered any con se quences other than no longer be ing in vited to places they
did not want to go in the first place—in a way the ideal out come for otro‐ 
verts. Giv ing our selves per mis sion to sim ply not show up is, in my ex pe ri‐ 
ence, one of the best ways otro verts can re duce the frus tra tion of try ing to
fit in, while also hon or ing their au then tic de sires and pro tect ing their valu‐ 
able time. As the Eng lish philoso pher and politi cian John Stu art Mill once
wrote, “The dan ger which threat ens hu man na ture is not the ex cess, but the
de fi ciency, of per sonal im pulses and pref er ences.”
PART III
THE VIRTUES OF BE ING AN
OTRO VERT
10
Emo tional Self-Suf fi ciency
It is an in escapable fact that all hu mans are born, live, and die alone. Sur‐ 
round ing our selves with oth ers makes it pos si ble to deny that fact. Group
mem ber ship al lows com mu nal peo ple to con vince them selves that theirs is
a shared fate, whereas be ing alone can re mind them of their true, soli tary
des tiny, which, for most, is an un com fort able and even in tol er a ble re al ity to
ac cept. The otro vert, on the other hand, does not feel part of a shared fate.
Be cause be ing alone is in trin sic to their life long ex pe ri ence, otro verts feel
com fort able in their soli tude.
How ever, in a group, the otro vert can not help but feel very lonely. Most
of the dis com fort orig i nates from try ing to fit in and play a role that is ex‐ 
pected of them, a per for mance otro verts find ex haust ing. When to geth er‐ 
ness is re as sur ing and pleas ant, sac ri fic ing en ergy for it makes sense. For
otro verts, that en ergy is twice wasted: one, the group’s pres ence does not
bring a sense of re as sur ance, and two, it is not pleas ant. Once otro verts un‐ 
der stand and em brace their need for soli tude, how ever, they are able to tune
out the ex pec ta tions of the group and in stead tune in to them selves.
Mem bers of a col lec tive must be mind ful of the other mem bers’ ap‐ 
proval or dis ap proval of them, and peo ple al most uni ver sally pre fer to be
liked rather than dis liked. This may re sult from the push to ward com mu nal‐ 
ity in early life, when we learn to as so ciate the ap prov ing smiles of our
care givers with food, safety, and all else that a help less in fant needs to sur‐ 
vive. Even at this early age, we dis cover that we will be re warded with af‐ 
fec tion and ap proval for re lin quish ing the in stinc tive self-cen tered at ti tude
we are born with and do ing what is ex pected of us.
In adult hood, the de sire to blend in and be ac cepted by the rest, the need
for recog ni tion from our peers, and the con stant “ne go ti a tion of needs” re‐ 
quired to win the af fec tion of other group mem bers en tail a deeper level of
sac ri fice that most are un aware of: the pro gres sive loss of emo tional self-re‐ 
liance.
The otro vert, un teth ered from the col lec tive, can dis tin guish be tween the
grav i ta tional pull of the group and their in ner, per sonal cen ter of grav ity.
They are not afraid to think the “wrong” thoughts or ex pe ri ence the
“wrong” feel ings, as they do not mea sure what is right or wrong against any
com mu nal yard stick. Be cause they don’t re quire group val i da tion, they are
in her ently self-suf fi cient: they rarely ex pe ri ence self-re crim i na tion or self-
loathing, and they never shame or guilt oth ers.
TRUST ING ONE’S IN STINCTS
As life un folds, otro verts learn to trust them selves in per sonal de ci sions.
They know them selves and what they need to make their life as pleas ant
and pro duc tive as pos si ble. They see them selves for who they are and know
what they can and can not do well. When, for ex am ple, they do a great job
on a work pre sen ta tion, they know it. They don’t ru mi nate about how they
did or wait for some one to tell them they did a great job and then won der
whether the per son meant it. This self-aware ness and self-re liance helps
them be de ci sive, will ful, and con fi dent in choos ing di rec tions in life.
As a nov el ist, Franz Kafka cre ated an un for get table por trayal of how the
otro vert mind set man i fests in the larger world.1 In books like The Trial, The
Meta mor pho sis, The Cas tle, and oth ers, he pre sented worlds in which be‐ 
long ing was con sid ered the in stinc tive, “nat u ral” way to be, writ ten from
the of ten be wil dered per spec tive of peo ple who are per se cuted for their in‐ 
abil ity to fit in.
But Kafka could also be much gen tler in shin ing a light on the vast lim i‐ 
ta tions of the be longer’s mind set. For in stance, in his short story “Josephine
the Singer, or the Mouse Folk,” he de scribes the work ings of the hive mind
with sub lime, wry hu mor, through the story of a mouse so ci ety strug gling to
de ci pher the tal ents of a mouse named Josephine, a fa mous singer. But de‐ 
spite her celebrity, it turns out that Josephine does not ac tu ally have any
par tic u lar mu si cal tal ent. Like all the other mice, she is merelywhistling
with no dis tinc tion. She is con sid ered to be a sub lime singer only be cause
the so ci ety has de cided to adore her; the be lief that she is spe cial and unique
re sults from the sur ren der of in di vid ual per cep tion to the col lec tive adu la‐ 
tion.
Kafka presents this sub mis sion to the group’s dic tum as the log i cal con‐ 
se quence of the “ter ri bly bleak and dif fi cult” life the mice live, one that af‐ 
fords no in ter est in or time for sub lime pas times like art and mu sic. Alone, a
mouse has no re prieve from its trou bles, but sit ting to gether, lis ten ing to
Josephine’s per for mance, the mice can for get their in di vid ual mis ery and
ex pe ri ence a shared plea sure. “Be ing car ried along day and night upon the
shoul ders of the com mu nity,” Kafka writes, is an at trac tive propo si tion for
peo ple who are con di tioned to fear be ing alone.
For com mu nal peo ple, suc cumb ing to col lec tive wishes is easy, and re‐ 
sist ing peer pres sure is very hard. Otro verts are the ex act op po site, as ev i‐ 
denced by an otro vert pa tient of mine when she got em broiled in a painful
cus tody bat tle with her abu sive hus band, who was re fus ing to pay child sup‐ 
port. Even when things got ugly, she con tin ued to fight, goaded on by her
lawyers and by all her friends and fam ily mem bers, who con stantly praised
her for stand ing her ground since she was very clearly in the right. At long
last, they re minded her, she had the op por tu nity to make him pay for all the
years of abuse, adding that this war of at tri tion against him was es sen tial to
“teach him a les son.” Her mother kept telling her, “What doesn’t kill you
will make you stronger,” but she told me, “I don’t feel I am get ting stronger.
It feels the other way around—in a way it is killing me.”
I gave her the ad vice I give to my otro vert pa tients in sim i lar sit u a tions:
Just walk away. No money or re venge is worth your peace of mind. On the
otro vert’s list of pri or i ties, peace of mind ranks high. They are un able to ac‐ 
com mo date toxic be hav ior and have a deep aver sion to con flict and con‐ 
fronta tion. Rather than sur ren der, most otro verts sim ply refuse to en gage in
a fight to be gin with. Be ing non com pet i tive makes los ing or win ning in con‐ 
se quen tial.
My pa tient felt a tremen dous sense of re lief and de cided to fol low my
ad vice, which was con sis tent with her own feel ings about the court case.
Pre dictably, her fam ily and friends were up set with her de ci sion and the
lawyers thought she was mak ing a grave mis take, but she fol lowed her heart
and re fused to abide by their ad vice. She came away feel ing strong for
stick ing by her con vic tions and pri or i tiz ing her own san ity rather than weak
for giv ing in to her ex.
THE NEED FOR SOLI TUDE
In his di aries, Kafka wrote, “Be ing alone has a power over me that never
fails. My in te rior dis solves (for the time be ing, only su per fi cially) and is
ready to re lease what lies deeper. When I am will fully alone, a slight or der‐ 
ing of my in te rior be gins to take place, and I need noth ing more.”
I can not think of a bet ter de scrip tion of the re lief and sat is fac tion an
otro vert ex pe ri ences when re treat ing into their true self.
Even when com mu nal peo ple are alone, they are not com pletely dis con‐ 
nected from the group; they are apart from them while con tin u ing to be in‐ 
flu enced by them. When an otro vert is alone, they are ab so lutely alone.
They do not com pare their thoughts with any one else’s, won der whether
their be hav iors are so cially ac cepted, or think about what other peo ple
might be do ing at that mo ment and why they weren’t in cluded. This free‐ 
dom from ex ter nal in flu ences gives them the men tal space to for mu late
orig i nal and imag i na tive ideas.
As we have seen, be ing an otro vert in a world that re wards join ers is not
with out its dif fi cul ties. The good news is that these chal lenges are far out‐ 
weighed by the strengths that otro verts pos sess. While Kafka pro duced
some of his most cre ative work “in soli tude”—where he was able to tap into
“this tremen dous world I have in side of me”—he also un der stood that
dwelling in his in ner world need not re sult in alien ation and es trange ment;
that one’s in ner world could be rec og nized and em braced as a guide to de‐ 
sign ing the full, happy, and pro duc tive life that most otro verts achieve.
This emo tional self-re liance is among the great gifts of non-be long ing,
but there are many oth ers as well.
Foot note
1 Franz Kafka, “Josephine the Singer, or the Mouse Folk,” A Hunger Artist
(Berlin: Ver lag die Schmiede, 1924).
11
Em pa thy and Con nec tion
Otro verts are not mis an thropes. In fact, peo ple are fas ci nat ing to otro verts,
and even if they can not feel an affin ity for or sense of be long ing within the
group as a unit, they are still able to bond one-on-one with each in di vid ual
within it (as we have seen, this is one way in which otro verts dif fer from in‐ 
tro verts, lon ers, and those with autism). D. H. Lawrence de scribed this otro‐ 
vert ten dency this way: “Per haps only peo ple who are ca pa ble of real to‐ 
geth er ness have that look of be ing alone in the uni verse. The oth ers have a
cer tain stick i ness; they stick to the mass.”
When it comes to friend ship, otro verts pre fer qual ity over quan tity.
Though they can not fathom how a group thinks col lec tively, have trou ble
fit ting into the so cial ecosys tems of their work places and com mu ni ties, and
don’t un der stand the plea sure taken in shared ac tiv i ties or the bon homie that
com mu nal peo ple find so com fort ing, a very good friend or two, and per‐ 
haps a long-term part ner, sat isfy the otro vert’s need for con nec tion and
com pany.
While many com mu nal peo ple are fair-weather friends—there for the
good times but likely to dis ap pear when you re ally need them—an otro vert
is al ways avail able to their friends when they are needed, with out ex pec ta‐ 
tion of rec i proc ity. Be cause the otro vert is in ca pable of the so cial jock ey ing
and mind games that so many com mu nal peo ple learn to em ploy, no one
ever has to doubt their mo tives; when they are kind and gen er ous, it is be‐ 
cause they find help ing oth ers re ward ing.
MEAN ING FUL COM MU NI CA TION
Be cause otro verts are both cu ri ous and friendly, they can strike up deep
con ver sa tions with peo ple dur ing rel a tively brief en coun ters; in fact, this is
the only way they know how to com mu ni cate. They can not bear small talk,
which the an thro pol o gist Bro nis law Ma li nowski, who was the first to re‐ 
search the so cial func tion of small talk, de scribed as “pur pose less ex pres‐ 
sions of pref er ence or aver sions, ac counts of ir rel e vant hap pen ings, [and]
com ments on what is per fectly ob vi ous.”
Most peo ple are made very un com fort able by si lence, es pe cially in the
com pany of peo ple they don’t know, and so many fill the void with chitchat
that is meant to es tab lish only su per fi cial con nec tion and pro vides no com‐ 
mon ground for mean ing ful com mu ni ca tion. Otro verts, on the other hand,
plunge right ahead with the “gen uine stuff,” as L, an otro vert friend of
mine, de scribes it. In ca sual en coun ters with strangers, L is very friendly
and warm. Of ten, the other per son will feel a con nec tion to him that goes
be yond what would be ex pected from ca sual small talk, and may even try to
con tinue the con nec tion by sug gest ing they meet again. When L po litely de‐ 
clines, and they re al ize that the warm friend li ness was not a pre lude to
friend ship—the otro vert’s thresh old for whom they con sider a friend is
quite high—but sim ply a pleas ant con ver sa tion in its own right, some are
baf fled as to how they mis read the signs. Oth ers get up set and re coil at what
they con sider an af front or even a be trayal.of sev eral dif fer ent friend groups through‐ 
out my child hood, yet I never felt like I truly be longed in any of them.
What ever wall sep a rated me from the oth ers was in vis i ble. No mat ter how
pop u lar I was, I al ways felt like an out sider.
Group ac tiv i ties that all my friends hap pily par tic i pated in—sports
teams, day camps, and camp ing, what most kids looked for ward to—were
very un pleas ant for me for no ap par ent rea son. But I feared that voic ing
these feel ings would make me seem strange or ab nor mal, so I pre tended to
look for ward to them just as much as all the other kids. Para dox i cally, I was
a pop u lar loner who learned to fash ion a cool, out go ing fa cade. To oth ers,
my jovial per son al ity seemed ef fort less. It was any thing but.
This cha rade be came in creas ingly hard to sus tain with the on set of pu‐ 
berty. On top of the typ i cal ado les cent emo tional tsunami, I was be sieged
by con fu sion and frus tra tion about my in abil ity to care about what ev ery one
else did. I des per ately wanted to en joy the affin ity my so cial group dis‐ 
played; I wanted to share the feel ing of “to geth er ness,” the gos sip, the tales
of sex ual con quest, the ob ses sion with sports teams, the en cy clo pe dic
knowl edge of ev ery Rolling Stones song ever writ ten, and ev ery thing else
that my peers—both male and fe male—seemed to de sire. But I could not
muster any gen uine ex cite ment or in ter est in any of it. I pre ferred au then tic
con ver sa tion—the ex change of con fi dences and truths, rather than su per fi‐ 
cial small talk and bravado—but as teenagers do, I faked what seemed re‐ 
quired of me. I learned the names of soc cer play ers, went to par ties, dressed
like all the cool guys, and let my hair grow long. When the con ver sa tion
turned to any thing even mildly con tro ver sial, from pol i tics to which girl in
the class was pret ti est to what we all thought of the lat est block buster
movie, I would wait to see what the group con sen sus was and go along with
it, even though I al most al ways dis agreed.
Out wardly, I was no dif fer ent from the other kids in the pro gres sive
school I at tended. My dis com fort was in ter nal. I did not dare share it with
any one. My around-the-clock per for mance may have been Os car wor thy,
but it left me feel ing empty and ex hausted.
Then, when I was in my twen ties, some thing changed. My la bored ef‐ 
forts to demon strate easy go ing kin ship with my peers grew un sus tain able.
As an un der grad u ate and then a med i cal stu dent, I had a rig or ous course
load, and spend ing my lim ited free time on ac tiv i ties I did not en joy be came
less and less ap peal ing. I craved op por tu ni ties to speak my mind and nur‐ 
ture close one-on-one friend ships, un en cum bered by group dy nam ics. I no
longer felt I needed the group’s ap proval to val i date my ex is tence, and I no
longer cared to let the ma jor ity opin ion in flu ence my views or de ci sion-
mak ing. I de cided it was time to stop per form ing.
Around this time, I also re al ized that my life long lack of con nec tion to
what moves and mo ti vates groups of peo ple made me an ex cep tion ally keen
ob server, al ways seek ing to de ci pher be hav iors that I found per plex ing. Un‐ 
en cum bered by any au then tic de sire to fol low the flock, I learned to con nect
pow er fully to in di vid ual peo ple rather than abide by tribal norms that sup‐ 
press deep, em pathic con nec tions and iso late us from those deemed out‐ 
siders. Be cause I al ways felt an arm’s length away from the col lec tive, I
could see its mem bers as in di vid u als, each with their unique emo tional re‐ 
sponses, pat terns, and per son al i ties. I now un der stood that in con stantly (if
silently) ques tion ing the group con sen sus, I had be come an out side-the-box
thinker who ap proached prob lems from new an gles that oth ers couldn’t or
didn’t want to see. In ad di tion, my dis in ter est in most pop u lar ac tiv i ties,
trends, and hob bies al lowed me to throw my self fully, and with laser-like
fo cus, into my in ter ests and stud ies.
In other words, this as pect of my per son al ity—this “non-be long ing”—
that had so baf fled my younger self was the very thing that en abled me to
forge a suc cess ful and deeply ful fill ing ca reer in psy chi a try. I was not an
ugly duck ling, nor was I a swan. I was an other kind of bird al to gether. Af ter
a bruis ing pas sage through ado les cence, this dis cov ery ex posed a thrilling
pos si bil ity: in stead of fol low ing the flock, I could chart my own tra jec tory.
The more I ob served and stud ied these per son al ity char ac ter is tics—in
my self, in oth ers like me whom I en coun tered, and in those pa tients for
whom no known di ag no sis could ex plain the sense of oth er ness they felt—
the more I was able to iso late a dis tinct set of traits that we all shared. As I
started writ ing about what I dis cov ered, I searched for a word to de scribe
peo ple like this—which, of course, in cluded my self.
Most peo ple are fa mil iar with Carl Jung’s con cepts of ex tro vert (“one
who faces out ward”) and in tro vert (“one who faces in ward”): terms that
have earned a rec og niz able place in the lan guage of pop u lar psy chol ogy.
But peo ple like me face nei ther in ward nor out ward: our fun da men tal ori en‐ 
ta tion is de fined by the fact that it is rarely the same di rec tion that ev ery one
else is fac ing. That is how I came up with the term “otro vert.” In Span ish
(et y mo log i cally in her ited from Latin), “otro” means “other” and “vert”
means “di rec tion.” Quite lit er ally, otro vert means “one who is fac ing a dif‐ 
fer ent di rec tion.”
Our so ci ety puts a tremen dous amount of em pha sis on the ben e fits of
com mu nity and be long ing. This is log i cal, es pe cially at a time when more
peo ple are re port ing suf fer ing the pro found ef fects of lone li ness, alien ation,
and dis con nec tion than ever be fore.
That so cial con nec tion con fers a va ri ety of health and men tal health ben‐ 
e fits is well doc u mented. But con nec tion is not the same as be long ing, de‐ 
spite the fact that the two are of ten equated in our so ci ety. When we say that
we “be long,” we are say ing that we feel at one with a group, be it a cir cle of
friends, a net work of col leagues, or a col lec tion of far-flung in di vid u als
united by a shared iden tity such as race, eth nic ity, sex ual ori en ta tion, and so
on. While it is true that we must ex pe ri ence some sense of kin ship with
mem bers of a group in or der to feel that we truly be long there, we do not
need to be long to a group in or der to feel a con nec tion with any in di vid u als
within it. Af ter all, if the in ten sity of our con nec tion with any one per son
was pred i cated on shared group mem ber ship, we wouldn’t ex pe ri ence gen‐ 
uine close ness with peo ple out side these iden tity-based group ings.
In the mod ern world, trib al ism (an other way of re fer ring to the com mu‐ 
nal im pulse that evo lu tion has sup pos edly equipped us with) does not make
us feel safer, less alien ated, or more con tent with our lives. One has only to
look at our po lar ized pol i tics to re al ize that, in fact, it does the op po site.
And yet, in a world where join ing and con form ing are highly val ued, be ing
an otro vert is of ten per ceived as a prob lem. Otro verts are fre quently ex‐ 
horted to “go with the flow” or “be a team player”: in other words, put their
true non-be longer na ture to the side in or der to fit into the so cial puz zle. Be‐ 
cause otro verts can be quite gre gar i ous and so cial when in ter act ing one-on-
one, peo ple are of ten con fused by their dis in ter est in join ing group ac tiv i ties
or re luc tance to at tend events where they will be forced to so cial ize with
many peo ple all at once.
If you fit in, oth ers will let you be. This is why many otro verts spend
theirL’s pre ferred con ver sa tional part ners are those who re spond to his at‐ 
tempts to dis patch with small talk in kind and join his im me di ate dive into
deeper top ics. But to the otro vert, even deep con ver sa tion does not have to
be a pre lude to a deep re la tion ship. It can be en joyed for what it is: a gen‐ 
uine ex change of opin ions and points of view.
Com mu nal peo ple have been con di tioned to be lieve that small talk is a
pre req ui site for a po lite so cial en counter; it is only otro verts who un der‐ 
stand that it is pos si ble to be friendly with out en gag ing in su per fi cial ex‐ 
changes. A col league of mine re calls how it took her mother, a first-gen er a‐ 
tion im mi grant and otro vert, up wards of a decade liv ing in Amer ica to get
used to the ab surd (in her view) ex change of pleas antries when in ter act ing
with store clerks and other strangers. “Why is she ask ing me how I’m do ing
to day? She doesn’t even know me,” she would grum ble about the friendly
cashier at the gro cery store the mo ment she was out of earshot.
Be yond small talk, the otro vert finds ab sur dity in any so cial rit ual to
which the group has ar bi trar ily as signed a sense of shared im por tance (gen‐ 
er ally speak ing, Al bert Ca mus’s no tion of life it self as ab surd is very com‐ 
pat i ble with otro vert per cep tion). For ex am ple, set tings in which peo ple
tend to take on an air of ar ti fi cial se ri ous ness or self-im por tance—like the
opera or an avant-garde art show—are cringe wor thy to the otro vert. They
can not par take in rit u als or cer e monies where there is a silent agree ment
among group mem bers that this is a solemn mo ment and ev ery one is ex‐ 
pected to play their role. That these rit u als are im por tant sim ply be cause the
group has deemed them so does not com pute for the otro vert.
There is a nice story in Ju daism about a vil lage fool who is so over‐ 
whelmed by the ser vices on Yom Kip pur that he puts two fin gers in his
mouth and whis tles loudly just as the rabbi is about to blow the sho far. The
con gre ga tion is hor ri fied and starts scold ing the em bar rassed man. But the
rabbi says, “No, let him be. He whis tled be cause that is how he can ex press
his re li gious fer vor. In fact, by his earnest act, he has opened the gate to
heaven, so we do not need to blow the sho far this year.” The otro vert un der‐ 
stands that rit u als have no in her ent mean ing be yond that with which we col‐ 
lec tively im bue them, and that by as sum ing that there is a par tic u lar “right”
way to act out that mean ing, we some times di min ish it. Otro verts are very
close to their be liefs and feel ings but pre fer to ex press them on their own
time and in their own way.
HU MOR AND CHARISMA
To man age their in tol er ance for what they con sider “unim por tant se ri ous‐ 
ness,” the otro vert will of ten be come silly and joc u lar. In some cases, this
can de rail se ri ous con ver sa tions or be seen as a sign of dis re spect for
solemn mo ments; in oth ers, it can pro vide a fresh breath of lev ity and
cathar sis ex actly when it is needed most. Be ing a per pet ual ob server rather
than a true par tic i pant lends the otro vert a par tic u larly strong radar for spot‐ 
ting the ab surd in ev ery day life, which can be great fod der for hu mor.
Though otro verts can be as en ter tain ing as stand-up comics, fo cus ing on
the ab sur dity in the mun dane and get ting big laughs from peo ple who will
none the less con tinue to be have the same as al ways, they never “punch
down.” They might poke fun at es tab lished norms or power struc tures but
pre fer self-dep re cat ing hu mor and ridi cul ing them selves to make a point.
This is how they de ploy hu mor with both em pa thy and charm.
12
Con fi dence and Con tent ment
Otro verts don’t need per mis sion, ap proval, val i da tion, or adu la tion in the
way that com mu nal peo ple do. Need ing to con vince no one of the “cor rect‐ 
ness” of their de ci sions or ac tions saves them from many un nec es sary con‐ 
ver sa tions and dis trac tions.
Be cause they are not gov erned by the per sis tent need to be liked, they
are able to set clear bound aries to pro tect their men tal en ergy and time.
They are the ul ti mate de ci sion-mak ers of what is friv o lous and what is pro‐ 
duc tive—and they make time for both.
Sta tus is al ways some thing mea sured rel a tive to other peo ple within a
so cial group ing, and be cause otro verts are not teth ered to such a group, they
never look to oth ers to mea sure the value of their choices, life style, or pos‐ 
ses sions. This also means they live with out FOMO (re call the story from
chap ter 1 of my pa tient’s son, whose mother was un duly wor ried about his
miss ing out on so cial ex pe ri ences). Be cause their de ci sions are their own,
unswayed by out side in flu ences, otro verts are quite con tent with their
choices. They can like and be com fort able with who they are with out the
need for ex ter nal val i da tion.
This dis in ter est in win ning the adu la tion of the col lec tive is ex em pli fied
in the ca sual way Kafka treated his lit er ary vo ca tion. It is telling that one of
the great est lit er ary gi ants in hu man his tory spent so lit tle time try ing to
pub lish or call at ten tion to his writ ings, and even went so far as to ask in his
will that his work be de stroyed af ter his death. When his friend and ex ecu‐ 
tor, Max Brod, went against his wishes, he did a great ser vice to hu man ity
but a dis ser vice to Kafka, who did not write for the pur pose of recog ni tion;
he wrote sim ply be cause he wanted to.
Due to their lack of FOMO and their dis in ter est in mark ers of sta tus,
otro verts gen er ally don’t feel en vi ous of oth ers’ fi nan cial suc cesses,
couldn’t care less about keep ing up with the Jone ses, and do not usu ally
covet what they do not have. They view earn ing money as a source of
safety—a means to make life eas ier rather than a goal—so they of ten have
quite dif fer ent fi nan cial and vo ca tional pri or i ties from those of the group.
They tend to be un happy and un suc cess ful if they try to work solely for the
pur pose of earn ing money, though those who can choose a ca reer cu rated to
their tal ent and mo ti va tion are of ten fi nan cially suc cess ful and ful filled by
their work. They are un likely to com pro mise their life style to get some thing
they don’t feel they need.
This doesn’t mean otro verts are nec es sar ily as cetic or fru gal. While be‐ 
ing clear on what they do and don’t need leads to a nar row, care fully cho sen
set of ma te rial pos ses sions, many otro verts love lux ury—par tic u larly the
abil ity to dis tance them selves from the mul ti tudes that it of fers. For ex am‐ 
ple, one otro vert I know lives a mod est life style but will al ways splurge on
first-class plane tick ets; she is will ing to pay an ex or bi tant pre mium not for
legroom or the three-course meal but for a mod icum of ad di tional pri vacy
and dis tance from fel low pas sen gers.
THE UL TI MATE AU THOR ITY ON THEIR OWN LIFE
Otro verts don’t like tak ing ad vice from any one short of pro fes sion als who
know things the otro vert does not. How ever, otro verts do not ac cept ad vice
on some thing they al ready have all the nec es sary in for ma tion about: them‐ 
selves.
Of ten, the goal of be long ing is at odds with the goal of en gag ing with
the world in ways that sup port rather than di min ish who we are. Be ing part
of a com mu nal group with its awe some grav ity can lead to self-ef face ment,
or at least to con fu sion be tween one’s true de sires and what the group
wants. To be in charge of your life and re la tion ships, you must have a
strong pri vate self that takes the needs of the group into ac count but does
not suc cumb to the com mu nal echo cham ber. Most peo ple are ex cited to
dis cover this self and learn how to bal ance what they want and need with
theplea sures and sup port they find in shared con cerns, pas sions, and oc cu‐ 
pa tions. For oth ers, it has been so long since they con sid ered their in di vid‐ 
ual needs that they’ve for got ten how to dif fer en ti ate their true wants and
wishes from the im plicit re quire ments for mem ber ship and ac cep tance
within a col lec tive. In our plu ral ist so ci ety, be long ing re quires con tin u ally
mak ing ad just ments to bring our choices more in line with our de sires.
When the bound ary be tween the in di vid ual and the group dis si pates, the
abil ity to dis tin guish be tween what you want and what the group wants
goes with it. Such was the case for my pa tient S when she joined a re tire‐ 
ment com mu nity, par tially on my ad vice. Re cently wid owed, with both of
her chil dren liv ing three thou sand miles away with their fam i lies, she de‐ 
cided to re lo cate. She wel comed the idea of com mu nity liv ing—she had al‐ 
ways been out go ing and friendly and was not wor ried about fit ting in or
find ing friends. She chose an el e gant gated com mu nity where she would
have a house of her own, large enough for her chil dren and grand chil dren to
visit. Per son ally, I would have made a very dif fer ent choice, but her “what
can go wrong?” at ti tude con vinced me she had made the right de ci sion.
Then, about three months af ter she had re lo cated, she called me in tears,
say ing, “I can not stand be ing here.” Be cause se niors are so prone to be com‐ 
ing iso lated, her new com mu nity put great stock in to geth er ness. The days
were filled with group ac tiv i ties: meals, book clubs, yoga classes, and many
other so cial op por tu ni ties. The prob lem was that the pres sure to par tic i pate
in these ac tiv i ties was suf fo cat ing; ev ery one in the com mu nity put pres sure
on ev ery one else to join, to make sure that no one ever stayed home alone.
In ad di tion, be cause she was a widow, the neigh bors as sumed she wanted to
meet men and were con stantly in tro duc ing her to wid ow ers. “It’s a liv ing
hell for me,” was how she de scribed it, “and the worst part is that my re luc‐ 
tance to at tend any ac tiv ity is viewed as a sign that I’m with draw ing, which
makes them dou ble their ef forts to ‘as sim i late’ me.” She was well aware
that all these peo ple were kind and had only good in ten tions, but she re al‐ 
ized they val ued to geth er ness in a way she did not. She re gret ted trad ing the
abil ity to be alone in the big city for this manda tory to geth er ness. For tu‐ 
nately, her apart ment had just gone on the mar ket, and she was able to pull
it back, giv ing her time to re think her de ci sion to re lo cate. One thing was
cer tain, though: she should not go back to the gated com mu nity, sur rounded
by peo ple so used to be ing to gether that they had lost the abil ity to dis tin‐ 
guish the in di vid ual from the col lec tive.
Com mu nal peo ple de rive enough joy from be ing to gether that it com‐ 
pen sates for the loss of their per sonal agency. But this is not the case for
otro verts like S, for whom that line be tween the self and oth ers was never
blurred.
Be cause otro verts take sole own er ship of their re spon si bil i ties and de ci‐ 
sions, they’re al ways work ing to min i mize neg a tive con se quences and bad
mem o ries, lead ing to ra tio nal de ci sions that make sense for them. For ex‐ 
am ple, I like to take walks on nar row coun try roads, but I am al ways very
care ful to make sure driv ers can see me clearly; I can never un der stand
those who sim ply as sume that driv ers surely see them. The re luc tance to
trust strangers with my life or well-be ing makes me risk averse but also pro‐ 
vides in ner calm.
Be ing the ul ti mate au thor ity in their own lives, otro verts do not rely on
the kind of re al ity check the hive em ploys to in form their per spec tives or
pref er ences. What seems ob vi ous to the rest may not seem ob vi ous to otro‐ 
verts, and vice versa. Un fazed by so cial trends, otro verts usu ally de velop
their own style of liv ing and stay faith ful to it. They re main un moved by
con sumerist pres sures, ad ver tis ing, and starred re views or other com mon
rank ing and rat ing meth ods that shape col lec tive pref er ences, and are un‐ 
likely to fall for scams or fad treat ments—even when rec om mended by a
cre den tialed doc tor—that make no sense to them.
Be cause they de cide on their own what makes sense rather than re ly ing
on group opin ion, all in for ma tion must pass the sen si cal/non sen si cal fil ter
in their mind. In vari ably, this mech a nism be comes dom i nant in their ev ery‐ 
day en coun ters. Though they need more time than the av er age per son to di‐ 
gest in for ma tion, this process frees them to form opin ions on what they
want to un der stand, rather than pas sively ab sorb the ma jor ity’s take on cur‐ 
rent events, cul ture, and ev ery thing else.
Most peo ple spend too much time wor ry ing about how they come across
to their co work ers and su per vi sors, their friends and neigh bors, some times
even their own fam ily mem bers. Even more of their pre cious men tal en ergy
is then ex pended won der ing what is the ap pro pri ate thing to do, the ap pro‐ 
pri ate thing to say, and whom to speak with ac cord ing to lo cal deco rum. But
the otro vert wastes lit tle time or en ergy think ing about such so cial con ven‐ 
tions. As John Lennon fa mously said, “Life is what hap pens to you while
you’re busy mak ing other plans.” Otro verts are not busy mak ing other plans
or won der ing about oth ers’ plans. They live very pow er fully in the here and
now.
Ac cus tomed to be ing mas ters of their own time, otro verts can be quite
im pa tient in sit u a tions they can’t con trol. They can’t stand hav ing to en dure
cer tain in con ve niences other peo ple grudg ingly ac cept as part of life—par‐ 
tic u larly those that re sult from hive mind be hav ior, such as a traf fic jam
formed be cause all the other driv ers on the road were rub ber neck ing at a
fender ben der; wait ing in an in ter minable line at the DMV be hind peo ple
who showed up with out the proper doc u men ta tion; or miss ing a flight be‐ 
cause of pas sen gers’ un ruly be hav ior at the se cu rity gate. I per son ally can
never un der stand peo ple who vol un tar ily choose to stand in line for any‐ 
thing. For com mu nal peo ple, a long line—be it for con cert tick ets, a ta ble at
a pop u lar restau rant, or the grand open ing of a new art ex hibit—sig nals
some thing that must be worth wait ing for. To otro verts like me, it feels like
a com plete waste of time.
As an im mi grant fa ther who had lived my en tire life with out ever hold‐ 
ing a base ball in my hands, I felt the need when my son was younger to do
some thing that I thought was a rite of pas sage for Amer i can kids: take him
to Dis ney land. We bought VIP tick ets to try to avoid hav ing to wait in the
no to ri ously long lines but then felt too guilty to use them once we saw all
the ea ger chil dren who would be forced to wait even longer to go on the
ride. Af ter thirty min utes, my then four-year-old said, “Daddy, if we leave
now we can still say we went to Dis ney land.” Elated, I com pletely agreed,
and we walked out with a sense of ac com plish ment.
13
Think ing Out side the Hive
In the early 1990s, I had the op por tu nity to run a schizophre nia unit at
Mount Sinai Hos pi tal in Man hat tan that was af fil i ated with a long-term psy‐ 
chi atric state hos pi tal. There were many pa tients there termed “treat ment
non re spon ders,” who ended up stay ing locked in this hos pi tal for the rest of
their lives af ter fail ing to re spond to treat ment. I had a great deal of sym pa‐ 
thy for their plight and would go to the hos pi tal once a week to find pa tients
in ter ested in reeval u at ing their treat ment. Most of them were hope less and
had given up on the prospect of do ing bet ter. Many were be sieged by hal lu‐ 
cina tions and delu sions, which meant they were too sick to give in formed
con sent. The pre vail ing opin ion was that these pa tients didn’t re spond to
treat ment be cause some thing about their con sti tu tion was dif fer ent, so we
looked for struc tural brain dif fer ences, meta bolic is sues, and other con di‐ 
tions that could al ter the ef fects of med i ca tions. In the vast ma jor ity of
cases, we came up empty-handed.
Based on my ex pe ri ence with those pa tients, I be gan to be bur dened by a
grow ing con cern that my col leagues and I were trapped in a cog ni tive dis‐ 
tor tion. Per haps these 20 per cent of psy chi atric pa tients were non re spon sive
not be cause some thing in them was wrong but be cause the treat ment was
wrong. In other words, per haps they had dif fer ent con di tions than the ones
they were be ing treated for. In psy chi a try, in di vid ual vari ables are of ten
over looked once a di ag no sis has been as signed. Pa tients are swiftly ad mit‐ 
ted into a group of sim i larly di ag nosed pa tients, who are even tu ally di vided
into two groups: those who “re spond” and those who do not “re spond” to a
cer tain med i ca tion reg i men.
In tel lec tu ally, I un der stood why things were done this way. Clin i cal
stud ies de mand a large num ber of par tic i pants, and group ing peo ple ac cord‐ 
ing to the symp toms they have in com mon is much more ef fi cient than
look ing for the ways in which their symp toms are dif fer ent. Yet, in my
mind’s eye, no mat ter how large a clin i cal trial, I still see a group of in di vid‐ 
u als. It was clear that I could not run a study of treat ment non re spon ders by
ex am in ing how each in di vid ual dif fered from ev ery other in di vid ual in the
test group. But I couldn’t help but share my idea with any one who cared to
lis ten—my stu dents, my col leagues, and even my pa tients’ fam ily mem‐ 
bers. It was ev i dent to me that the lack of a re sponse to med i ca tion that
works for sim i larly di ag nosed pa tients meant that there was a mis match be‐ 
tween med i ca tion and di ag no sis, yet the “nor mal” way of deal ing with
those pa tients who re mained symp to matic was to make them wait for “new
and im proved” ver sions of the med i ca tion they were not re spond ing to.
This com pletely flawed logic meant that thou sands of pa tients lan‐ 
guished in locked fa cil i ties for years, and more of ten than not, if some new
drug did come along, they were passed over for it, as the in sti tu tions where
they lived were more in ter ested in keep ing the pa tients calm (of ten with a
large dose of tran quil iz ers) than they were in ac tu ally treat ing them. Once a
non re spon der was com mit ted to a long-term-care in sti tu tion, they would
have lit tle to no chance for an ac tive, on go ing re view of their con di tion; no
ef forts would be made to fur ther in ves ti gate why the “right” med i ca tions
were elic it ing the wrong re sponses (in this case, no re sponse at all) or to re‐ 
visit their di ag no sis pe ri od i cally with new per spec tives born of ad vances in
psy chi a try and medicine dur ing the decades they had spent locked up in a
hos pi tal. Reeval u at ing each of the non re spond ing pa tients’ con di tions
seemed like an in sur mount able task. Hav ing no sup port from the in sti tu‐ 
tions, I moved on to other projects, though I couldn’t stop think ing and talk‐ 
ing about my idea to study non re spon ders to any one will ing to lis ten.
Two years later, I was walk ing in Mid town Man hat tan when I bumped
into a friend who was the di rec tor of that same psy chi atric state hos pi tal that
I had vis ited weekly. A hos pi tal ad min is tra tor with no med i cal back ground,
she had then al ready been deeply ded i cated to the pa tients un der her charge.
She and I used to take cof fee breaks with some of her staff, and I would tell
them about my idea of giv ing non re spond ing pa tients a sec ond chance.
When I ran into her two years later, she was on her way to lunch and sug‐ 
gested I join her. There, she told me she had re cently been pro moted to as‐ 
so ciate com mis sioner in the Of fice of Men tal Health, the New York State
agency over see ing all the men tal health ac tiv i ties around the state. I told her
I was very happy for her pro mo tion, and I was; it is won der ful when such
tal ented and ded i cated peo ple are rec og nized. Then she asked me, “What’s
go ing on with your sec ond-chance pro gram?”
I told her about the ob sta cles—aca demic, fi nan cial, ad min is tra tive, and
more—I had en coun tered in try ing to find a place to test my hy poth e sis.
She said, “I think I have a way. But it would re quire a great sac ri fice on
your part.” She then went on to ex plain that her state agency was look ing
for a young and pas sion ate med i cal di rec tor for op er a tions and asked if I
would agree to meet the state com mis sioner and con sider the po si tion. I
knew that she shared my propen sity to “think out side the box,” and the
thought of work ing to gether sud denly re vived the sec ond-chance idea as a
real pos si bil ity.
The next week, I met with the com mis sioner of men tal health. He was a
lovely, highly in tel li gent, and gen tle per son, and I liked him from the first
mo ment. He was not a physi cian but a sea soned so cial worker who had
risen from the trenches and was very fa mil iar with the sys tem. I gave an im‐ 
promptu pre sen ta tion of my ra tio nale and strat egy for the sec ond-chance
pro gram, and he said, “I like your way of think ing. We need you in Al‐ 
bany.” I was still hes i tant, as the idea of com mut ing two and a half hours to
Al bany was daunt ing. “I hope you will ac cept the po si tion,” he said, adding
jok ingly, “You may not have a sec ond chance to carry out the pro gram.” He
was right. This was a unique, un so licited, one-time op por tu nity. This for tu‐ 
nate co in ci dence, in the chance meet ing with my friend on the street, would
never re peat it self. I had to do it. I ac cepted un der the con di tion that I would
not re lo cate to Al bany but stay with my fam ily in Man hat tan, com mut ing
weekly in stead. I never re gret ted it.
The tran si tion was smooth, but the job was enor mous in scope, and I
barely lifted my head to breathe for a year. The dif fi cul ties and ob sta cles
were many and var i ous, in clud ing reg u la tory, fi nan cial, strate gic, and
staffing prob lems. Then there was the back ground drum beat of naysay ers
among psy chi a trists who were trapped in the afore men tioned group think.
My pro posal to re visit each pa tient’s di ag no sis and symp toms for dif fer ent
treat ment strate gies rather than look ing for ver sion 2.0 of the same treat‐ 
ments seemed an tag o nis tic to the pre vail ing ethos. Which was, in a sense,
ex actly the point.
The first pa tient ar rived at the aca demic psy chi atric hos pi tal twenty-two
years ago, and the Sec ond Chance Pro gram has been in ex is tence ever
since. At the out set, we worked with those who had been hos pi tal ized for a
me dian time of twenty years. Many of those peo ple had lost any abil ity to
func tion on their own—a di rect re sult of many years spent locked in a psy‐ 
chi atric unit with other se verely ill pa tients and no re spon si bil i ties, agency,
or path to ward a bet ter life. Some pa tients, we soon dis cov ered, were not
men tally ill at all, but had been ad mit ted at a time when knowl edge about
var i ous other con di tions, such as Tourette’s syn drome, was lim ited. Most
pa tients had never used any elec tronic de vices, did not know how to shop,
how to make food, how to do their laun dry, or how to per form the myr iad
other ac tiv i ties of daily liv ing that most peo ple con sider rou tine and triv ial.
Now they had to learn or re learn those skills, along with how to use pub lic
trans porta tion, pay bills, show up for ap point ments, and in ter act with
strangers in a way they hadn’t done since they were admit ted. Each pa tient
who re cov ered symp tomat i cally but was too bro ken to mas ter the skills
needed to live in de pen dently got a place in a pro gram that of fered pro tec‐ 
tive liv ing as well as a full range of so cial and med i cal ser vices. Since then,
hun dreds of pa tients have been tran si tioned back into the com mu nity.
Though it has been many years since I left that gov ern ment po si tion, to
this day few mo ments bring me more joy than when I sit with my young
res i dents and they say, “This pa tient seems like a good can di date for the
Sec ond Chance Pro gram. Are you fa mil iar with that?” At which point I
smile un der my mus tache and an swer, “Yes, to a cer tain ex tent,” and let
them tell me about it.
Start ing this pro gram is per haps my most en dur ing legacy, and my
proud est ex am ple of what can be achieved by work ing around the sta tus
quo. I will ad mit that for many years be fore ac tu ally launch ing the pro gram,
I suc cumbed to ev ery one telling me my idea was both im pos si ble and fu tile.
This would be the last time I would al low a fig ure of au thor ity—or any one
—to make me be lieve that I was wrong just be cause no one else thought I
was right. It showed me defini tively that we (un for tu nately) live in a cul ture
that puts stick ing with the con sen sus opin ion above all else, even when that
means de priv ing vic tims of a bro ken sys tem of a sec ond chance to par tic i‐ 
pate in life. And it so lid i fied my con vic tion that our so ci ety des per ately
needs more per spec tives and ideas that do not con form to the con ven tional
wis dom dic tated by the hive mind.
THE AB STRAC TIONS OF THE COL LEC TIVE MIND
Emily Dick in son once wrote, “The soul se lects her own so ci ety.” Yet for
many souls, one’s po si tion in so ci ety is not so much a choice as it is a func‐ 
tion of where we live, what fam ily, re li gion, or so cial class we were born
into, and what eth nic ity and/or race we are. Most peo ple em brace—or at
least ac cept—the so cial groups to which they have been as signed. Otro verts
do not. They place no trust in any group formed around an ab stract idea or
cir cum stance of birth, such as ide ol ogy, pol i tics, race, econ omy, re li gion,
and na tion al ity, which ex ist only in the col lec tive mind. For them, the idea
of un ques tion able de vo tion to a group of peo ple linked by a set of tacit cri‐ 
te ria agreed upon by the group’s mem bers makes lit tle sense, no mat ter how
ven er a ble that group is in the eyes of the ma jor ity.
Most hu mans ad here to these bind ing ab strac tions for var i ous rea sons—
many of them com pletely valid. Mem ber ship in a group of peo ple who
share our ide ol ogy, back ground, or as pects of our ex pe ri ence cre ates a path
for con nec tion, which is es pe cially ap peal ing when other ob vi ous routes,
such as fam ily or work, aren’t avail able. Such groups also pro vide a set of
un writ ten in struc tions about how to be have, which helps to ward off am bi‐ 
gu ity and un cer tainty, while also keep ing ev ery one in line. When things are
good, these af fil i a tions pro vide a sense of shared iden tity, and with it a
crude way of de ter min ing who is a friend to be trusted and who is a foe to
be feared. And when things are bad, as men tioned ear lier, the group ethos
be comes hugely im por tant in de cid ing how best to nav i gate the cri sis and
what might need to be sac ri ficed in its name. Though we no longer need to
be part of a tribe to sur vive preda tors or the threats of the nat u ral world,
most peo ple do still need it to sur vive the very ex pe ri ence of be ing hu man.
Un like most herd an i mals, which co op er ate pas sively, hu mans can co op er‐ 
ate ac tively by cre at ing a no tional en tity based on many peo ple agree ing to
share the same opin ions and be liefs. A hive mind cre ates “col lec tive in tel li‐ 
gence” or “com mu nal wis dom” by pool ing ex pe ri en tial re sources. Most of
us learn to con form be cause be long ing to or par tic i pat ing in the hive mind
pro vides il lu sory pro tec tion: the be lief in strength in num bers. And as the
group’s size in creases, the de mands for con form ity in ten sify, as it ce ments
the unity nec es sary for the group’s rule. This urge to be long sub sumes all
that is dis tinc tive about a per son once they be come a mem ber of the hive.
For most peo ple, this sac ri fice is made eas ily and in stinc tively. Not so
for otro verts, who are nei ther will ing nor able to pas sively adopt the so cial
scripts that oth ers do. To the otro vert, who is con stantly en gaged with the
choices and con se quences of their in di vid ual life, so cial norms fol low a cir‐ 
cu lar logic: the rea son peo ple fol low them is be cause they have been widely
ac cepted, and the rea son they have been widely ac cepted is be cause many
peo ple fol low them. To high light the ar bi trary na ture of such rules, an otro‐ 
vert might put it this way: If you were stranded alone on a desert is land,
would you still value ev ery thing that you value or were taught to value? Or
would you re al ize that most of these judg ments are use ful and rel e vant only
in the con text of other hu mans?
Non-be long ing is kind of like liv ing life on an is land, while be longers
are on the main land. When otro verts visit the main land, they pay at ten tion
to the pre vail ing rules and try their best to abide by them, but they are al‐ 
ways ac ci den tal tourists there. The rules are of no use to them else where.
Otro verts can not be con vinced of the va lid ity of an idea sheerly through
the num ber of peo ple who hold it. It is the idea it self that mat ters. The tools
of the hive mind—con sen sus, ma jor ity, com mu nal wis dom, and ex pe ri ence
that come down through the gen er a tions—are use less to the otro vert if the
con cept be hind the idea seems wrong to them. On the other hand, a wise
ob ser va tion or state ment made by some one, ir re spec tive of po si tion or au‐ 
thor ity, can be pro foundly ap pre ci ated by an otro vert if it strikes them as
true.
As a very young man, I had my heart bro ken. Noth ing any one said—
none of the usual plat i tudes—pro vided any source of com fort. Then a
Bedouin waiter in a tea shop I fre quented said to me, “A bro ken heart is like
a burn. At first, it hurts all the time, then only when you touch it, and even‐ 
tu ally, it does not hurt at all. There might be only a faded scar to re mind
you.” This was forty-five years ago. He was very right, and I still im part
Wa did’s wis dom to oth ers.
FREE THINK ING AND ORIG I NAL ITY
Be long ing ness and con sen sus do not lend them selves to orig i nal ity. Un en‐ 
cum bered by the hive mind, otro verts are orig i nal thinkers. They see what
ev ery one else sees, but be cause they are not sub or di nate to the grav i ta tional
pull of group think, they al low them selves to pon der al ter na tive in ter pre ta‐ 
tions. And due in part to their dis in ter est in pop u lar cul ture and other mass
en ter tain ment, they have the men tal space to em bark reg u larly on in tel lec‐ 
tual ad ven tures fu eled by in tro spec tion and cre ativ ity. This opens the pos si‐ 
bil ity of stum bling on serendip i tous ob ser va tions that elude the col lec tive.
Be cause they stray from the pre vail ing think ing, their ideas of ten seem rad i‐ 
cal or even threat en ing. This is true of vir tu ally all truly orig i nal thinkers
through out hu man his tory, both the fa mous ones we have all heard of and
the ones lost to the an nals of the past.
Dr. Ig naz Sem mel weis, a Hun gar ian physi cian, falls in the sec ond cat e‐ 
gory. In 1861, he pub lished a book called The Eti ol ogy, Con cept, and Pro‐ 
phy laxis of Childbed Fever, which de scribed his re search on ma ter nal death
dur ing child birth from what we now call puer peral fever. His con clu sion,
rev o lu tion ary for those times, was that these deaths could be pre vented
merely by doc torswash ing their hands be fore as sist ing in de liv ery. Nowa‐ 
days, it is ob vi ous that med i cal pro ce dures should be per formed un der ster‐ 
ile and clean con di tions to pre vent con tam i na tion, but germs and their pu ta‐ 
tive role in in fec tion were un known in his day. Dr. Sem mel weis de duced
the con nec tion in what was then an un con ven tional way: by vis it ing a de liv‐ 
ery clinic where the women who gave birth were con tract ing childbed fever
in sig nif i cantly lower num bers.
Upon ob serv ing the mid wives who ran this clinic, he found only one dif‐ 
fer ence in their meth ods: many of the doc tors at the hos pi tal as sisted with
la bor im me di ately af ter per form ing au top sies, while the mid wives didn’t.
He con cluded that the physi cians might be trans fer ring what he called “or‐ 
ganic ma te rial” (i.e., germs and bac te ria) from the au topsy to the de liv ery
via their hands and sug gested that they wash care fully be fore de liv er ing a
baby. Though deeply skep ti cal that some thing so triv ial as hand wash ing
could make a mea sur able dif fer ence, the doc tors took his sug ges tion. When
they did, the ma ter nal death rate at the hos pi tal im me di ately dropped from
18 per cent to 2 per cent.
Dr. Sem mel weis knew noth ing about bac te ria and their role in in fec tion;
he sim ply saw some thing that no one else in the clin ics was able to see, and
this sin gle in sight was enough to pro foundly al ter the hor ri ble re al ity of the
many women dy ing from in fec tion. Like most in no va tions, though, Sem‐ 
mel weis’s dis cov ery was re ceived very poorly by his col leagues. Even af ter
the suc cess of his in ter ven tion had been clearly demon strated, they de‐ 
manded a the o ret i cal ex pla na tion as to why hand wash ing re duced mor tal ity,
some thing that Sem mel weis could not pro vide. He was shunned by the
med i cal so ci ety, was fired from his clin i cal and aca demic po si tions, and suf‐ 
fered an emo tional break down. His col leagues then com mit ted him to an
asy lum, where he was beaten by the or der lies. He died ten days later from
sep sis caused by his dirty wounds (the irony is very poignant), at the age of
forty-seven.2
The ideas that emerge from the otro vert mind carry the risk of be ing
viewed as sub ver sive, heretic, or even in sane, even when the ev i dence
clearly sug gests oth er wise.
In a so ci ety gov erned by the com mu nal or der, the otro vert’s way of
think ing is threat en ing. But at a time when the chal lenges we face as a so ci‐ 
ety re quire us to ques tion con ven tional as sump tions, con tem plate prob lems
from new per spec tives, and open our minds to un ortho dox so lu tions, the
otro vert’s way of think ing also has the power to change the world.
MEM ORY AND TIME
The hive mind ex ists pri mar ily in the present, fu eled by an in ces sant in ter est
in the zeit geist: news, pol i tics, pop u lar cul ture, and gos sip are the build ing
blocks for shared ex pe ri ence. Along with this comes rel a tive dis in ter est in
yes ter day’s news; to stay men tally syn chro nized as a sin gle group, ev ery one
within that group has to keep shift ing their at ten tion to the next thing, which
is why the hive mind has a per pet ual shared in ter est in the now.
It is worth adding that fo cus ing on the shared now should not be con‐ 
fused with mind ful ness, as mind ful ness is ex er cised in di vid u ally. Whereas
the hive mind con sid ers the present through the lens of shared ex pe ri ence, it
con sid ers the past through shared mem o ries, myths, fa bles, and tra di tions,
each one a thread in the col lec tive his tor i cal con text that of ten dwarfs any
in di vid ual’s per sonal past. Sim i larly, plans for the fu ture are largely dic tated
by the col lec tive doc trine of what is wrong, right, ap pro pri ate, or wor thy.
The same oc curs when it comes to col lec tive de lib er a tions re gard ing the
con se quences of cur rent ac tions. If this were not the case, it would be im‐ 
pos si ble to un der stand how each gen er a tion can re peat anew the grave mis‐ 
takes of the past and be sur prised by the “un in tended” con se quences.
Un teth ered from the hive mind, otro verts per ceive their place in his tory
and time dif fer ently. Their per sonal ex pe ri ence of the present mo ment is not
linked to that of all the other peo ple who are also ex pe ri enc ing it, and their
mem o ries of the past are not clouded by the col lec tive nar ra tive. Be cause of
their min i mal con nec tion to con tem po rary cul ture, mores, trends, and so on,
their mem o ries are more per sonal and rarely con tem po ra ne ous with those of
any other hu man. If you asked a group of peo ple to re count their mem o ries
of a par tic u lar mo ment in time, many of them would likely cite the song
that was al ways play ing on the ra dio or the style of cloth ing that was in
vogue, whereas otro verts would re count a spe cific ex pe ri ence they had had.
Otro verts, in other words, fo cus not on col lec tive mem ory but on the self
and their per sonal voy age through time. As a re sult, the otro vert’s sense of
time is lon gi tu di nal: to day is an out come of yes ter day, and to mor row is a
con se quence of to day. Ev ery mo ment, and ev ery mem ory, is as pre cious as
the last.
Foot note
2 Howard Markel, “In 1850, Ig naz Sem mel weis Saved Lives with Three
Words: Wash Your Hands,” PBS.org, May 15, 2015.
14
The Rich ness of In ner Life
When I work with pa tients, I see my role as that of a sherpa who can
guide them in nav i gat ing ter ri fy ing ter rain they wouldn’t dare to ex plore
alone. I am re fer ring here to their in ner lives.
This con fronta tion with the self is fright en ing and over whelm ing for
most peo ple. Be cause no one has ac cess to our in ner thoughts, our in ner
world is the one place where we are truly, un avoid ably alone. And so, be‐ 
cause as so cial an i mals we tend to feel dis com fort with alone ness, most hu‐ 
mans deal with their in ner world by pay ing lit tle at ten tion to it. But as with
most re la tion ships in life, ne glect ing our re la tion ship with our in ner world
brings mal func tion, as in sights that could have bet ter con nected our ex pe ri‐ 
ence with our deeper knowl edge of our selves are lost.
As a re sult, we base many de ci sions (con sciously or not) on a faulty, in‐ 
com plete set of data. We ex pect to be able to rely on our in stincts—or what
we call “a gut feel ing”—for the most im por tant, in ti mate de ci sions, but be‐ 
cause we don’t pay at ten tion to our in stincts most of the time, call ing on
them in ur gent mo ments can steer us wrong. In the ab sence of a strong in‐ 
ter nal com pass, we con fuse the “com mu nal wis dom” for our own per son‐ 
ally in formed com mon sense. And when our in ner con vic tions, val ues, and
pref er ences come into con flict with those of the col lec tive, we learn to
aban don or sup press them to align with the hive and win so cial ac cep tance.
Even tu ally the in ner world is so in ac ces si ble and in com pre hen si ble that
it be comes a bur den. We might call this burnout, midlife cri sis, or de pres‐ 
sion. But in truth it’s the re sult of clos ing our selves off to our most pri vate
thoughts and dreams and de sires, which we are con di tioned to be lieve can
be wrong or in ap pro pri ate or self ish, even if we never act upon them. The
sense of awe that came nat u rally to us as chil dren gets squeezed out of us,
leav ing us no choice but to con jure or feign en thu si asm for what the group
con sid ers awe some. It’s no won der peo ple look for psychedelics to probe
the depths of their in ner ex pe ri ence; they’re bored with the er satz imag i na‐ 
tion the group feeds them.
For most peo ple, the com min gling of the phys i cal world, the com mu nal
world, and their in ner world cre ates fluid bound aries be tween the self and
oth ers. Otro verts, on the other hand, have a strong de mar cation be tween the
two. They know it’s pos si ble to ex ist in both their in ner and outer worlds—
but they are hy per aware of the bound ary be tween them. They can not ac cess
the au topi lot mode that al lows com mu nal peo ple to drift be tween these two
worlds and flow in obliv i ous har mony with the rest.
This dis con nect be tween the self and the other comes with real ben e fits.
It is why otro verts are able to tune out many of the con cerns that oc cupy
com mu nal peo ple, like envy and shame, and in stead tune in to them selves.
Tuned in to their rich, mul ti lay ered in ner worlds, they gain ac cess to a fan‐ 
tas ti cally com plex uni verse of thought, mem ory, and imag i na tion that the
com mu nal per son can not ac cess.
To my pa tients who ex tol the virtue of psy che delic trips I say, I can
reach the same ex pe ri ences with out drugs, as I never lost ac cess to the psy‐ 
che delic as pect of my imag i na tion. Un like those who have aban doned their
in ner world to dwell per ma nently in the com mu nal realm, otro verts pre fer
the com plex ity of their in ner worlds to the shal low in ter ac tions and pedes‐ 
trian con cerns that pre oc cupy the col lec tive.
Many com mu nal peo ple are so fear ful of ex pos ing their deep est dreams
and de sires, they will at tempt to take the rules of the so cial world we live in
and ap ply them to their in ner lives as well. For ex am ple, let’s say I envy
some one for his sports car. As an otro vert, chances are that I won’t even ex‐ 
press those feel ings aloud, much less act on them. Otro verts un der stand that
their in ner mind is pri vate, and they pro tect this pri vacy by en sur ing that
their deep est feel ings are made pub lic only to the ex tent they de cide to
share them. But I also won’t deny these feel ings to my self, nor will I feel
bad about hav ing them. I feel per fectly free to in dulge all my most cov etous
and (some would say) unattrac tive in stincts in my own mind. As a re sult, I
am not tor tured by them.
But a com mu nal per son, whose bound ary be tween their in ner and outer
worlds is much more por ous, does not want their less at trac tive in stincts—
like petty envy or jeal ousy—laid bare to the world and of ten feels guilty,
em bar rassed, or ashamed for things they can not con trol in their in ner di a‐ 
logue. To be free of this im pulse means aban don ing the idea of try ing to po‐ 
lice their in ner most emo tions or urges. Sim ply know ing that one’s in ner
world is not sub ject to the rules of so ci etal deco rum is im mensely lib er at‐ 
ing, as is the idea that thoughts and feel ings can not be wrong or right, if
only be cause we can not con trol them.
Most uni ver sal rules of in ter per sonal be hav ior are handed down and
main tained by so ci ety at large, re quir ing no in put from you. Our in ner, in‐ 
trap er sonal gov ern ing prin ci ples are an other mat ter. Your in ner world is a
place where you can think what ever you want, so long as you don’t act it
out and don’t try to con vince oth ers of it. You’re not be holden to any so cial
mores, be cause they are de signed to gov ern your in ter ac tions with oth ers.
You are, in the most pro found sense, free.
LAN GUAGE AND THE PSY CHE
When in ter act ing with the so cial world, we all use words that con dense the
rich ness of our emo tional ex pe ri ence to sound bites. Com mu nal peo ple are
typ i cally con tent to live in a world where ev ery thought and sen ti ment has
been re duced and sim pli fied for ease of con sump tion and ef fi ciency of com‐ 
mu ni ca tion. This is a world where a feel ing like love is turned into a uni ver‐ 
sal term that is just as likely to be used to de scribe how we feel about a car,
an old pair of shoes, or our job as it is to de scribe our feel ings about our
child or our life part ner. Next time some one tells you they love their part ner,
ask them what they mean by “love,” and you will be sur prised by how dif fi‐ 
cult it is for them to ar tic u late it.
In deed, as we grow out of in fancy and be gin to use lan guage to ex press
our selves, we learn to sup press and re strict the full range of our in ner ex pe‐ 
ri ence to what can be ex pressed. Even tu ally, our imag i na tion, our sense of
won der ment and cu rios ity, be comes very hard to talk about, as we can not
ex press these con cepts in words, and even tu ally we for get about them al to‐ 
gether. We be come de tached from un shared thoughts and yearn ings, as they
are sub merged into the elu sive depth of the un con scious mind.
This is a trap otro verts can dodge. Their strong de mar ca tion be tween
them selves and oth ers al lows for two sep a rate lan guages: one ver bal, for
pub lic in ter ac tion, and one non ver bal, or pre ver bal, for com mu ni cat ing with
the self. Those who ac cept ver bal lan guage as the only lan guage of the
mind re mem ber mostly through words. The otro vert re mem bers in feel ings
that can not be ar tic u lated in words; these feel ings are less likely to get lost
in the re cesses of mem ory, where they be come ir re triev able.
It’s sim ple to tell a story about an ex pe ri ence in the phys i cal world,
which is how most peo ple com mu ni cate ef fi ciently. But ex plain ing our in‐ 
ner world to oth ers is not part of ev ery day hu man dis course. Since even the
best spo ken among us do not have the vo cab u lary to ar tic u late our deep est
thoughts and de sires, they be come lit er ally un speak able. Other than great
artists, most of us can not ex press the rich ness of our in ner ex pe ri ence; when
con veyed in words, most de scrip tions be come a pale replica of the ex pe ri‐ 
ence. Even otro verts re main lim ited in ex plain ing their in ner world to oth‐ 
ers, no mat ter how close the other per son might be. This was why I could
not ex plain to my mother why I didn’t want to join the Scouts; I lacked the
vo cab u lary to ar tic u late why I sim ply did not find it at trac tive and to de‐ 
scribe the in ner con flict that arose in me when I heard the care free laugh ter
of the other boys as they boarded the buses to em bark on their ad ven ture.
Of course, the fact that oth ers can not ac cess the depth of our psy che is
not a bad thing in ev ery day life. Imag ine a world in which ev ery one could
eas ily read the thoughts and feel ings of ev ery one else. We would have
never been able to live to gether!
For the otro vert, dwelling in a rich in ner world that no other hu man can
ac cess pro vides much needed soli tude. It is a place where they can re treat
from the chaos of the col lec tive, a place that be longs to them and them
alone. As nov el ist Pearl Buck once said, “In side my self is a place where I
live all alone and that is where I re new my springs that never dry up.”
PART IV
THE OTRO VERT LIFE
15
The Otro vert Child
As you know by now, in the first years of life, ev ery child is an otro vert.
The in ner world is fa mil iar, while the out side world is baf fling and of ten
scary. At this young age, in fants spend hours float ing in side their own
minds; they quickly be come anx ious and cry in the pres ence of strangers
and must be drawn out of them selves to en gage with the com mu nal world
around them. As early as tod dler hood, they re al ize the perks of sac ri fic ing
their needs for the sake of group mem ber ship and plunge un ques tion ingly
into a quest for be long ing that lasts the rest of their lives. Ex cept, of course,
for otro vert chil dren, who dis play some or all of the fol low ing qual i ties.
They have an affin ity for adults over peers. Un like shy kids, who may
cling to their moth ers or fa thers in the pres ence of other grown-ups, otro vert
chil dren feel com fort able en gag ing with adults. Be cause they spend so
much time silently ob serv ing the adults around them, they are bright and
funny and of ten say things much more ma ture and so phis ti cated than ex‐ 
pected for their age. Though re served around other chil dren, they dis playa
pre co cious con fi dence with adults and are of ten the dar lings of shop own‐ 
ers, other kids’ par ents, teach ers, and any adults who in ter act with them, all
of whom mar vel at the child’s man ners, thought ful ness, and ma tu rity. In the
younger years, their so cial be hav iors may vary, but one qual ity re mains
con sis tent: the otro vert child is rarely child ish, even as a tod dler.
They have a cu ri ous and in ven tive mind. In their el e men tary school
years, otro vert chil dren are preter nat u rally cu ri ous and be gin to ask prob ing
ques tions that chal lenge con ven tional wis dom and ap proach ac cepted
knowl edge from a dif fer ent per spec tive. Among the ones I have fielded
from young otro verts: “How can you do mouth-to-mouth re sus ci ta tion
when we in hale oxy gen and ex hale car bon diox ide?” “If the fruit is alive
only when con nected to the tree and once picked starts dy ing, isn’t it like us
since we also start dy ing when dis con nected from the um bil i cal cord?”
And, per haps most telling of all: “If you tell me not to ac cept any one’s ideas
and to think for my self, can I also ig nore that ad vice?” These are the hall‐ 
marks of a per son who will con tinue to ques tion things that most peo ple
blindly ac cept for as long as they live.
In later child hood, as ed u ca tion be comes more for mal ized, the de sire to
do well in school of ten comes into con flict with the otro verts’ need to think
for them selves. The ed u ca tional sys tem is, af ter all, based on com mu nal no‐ 
tions, and otro vert chil dren may ex pe ri ence an in ner re bel lion as they strug‐ 
gle to un der stand why they are ex pected to ad here to rules that do not make
sense to them. Be ing spe cial ists rather than gen er al ists, otro vert chil dren are
idio syn cratic learn ers who can get lost in their own minds. The more in ter‐ 
ested they are in a sub ject, the more deeply they delve into it, even if it
comes at the ex pense of fo cus ing on what is at hand. They tend, there fore,
to ap pear dis or ga nized or bad at time man age ment, spend ing a lot of time
on some home work as sign ments while ig nor ing or putting off oth ers. Ir re‐ 
spec tive of their in tel li gence level, they rarely get straight As the way that
bright com mu nal chil dren do; rather than get ting per fect scores on all sub‐ 
jects, otro verts ex cel at what they have an in ter est in.
In my so cial sur vival skills pro gram for otro vert kids who have dif fi cul‐ 
ties get ting or ga nized, I urge par ents to watch for the line be tween sup port‐ 
ing their chil dren’s in de pen dent think ing and in ner de fi ance of au thor ity
and en abling an out ward de fi ance of au thor ity. In other words, if a child’s
otro vert traits are only the o ret i cally dis rup tive to their school ing, let them
be. But if a child’s otro vert traits be gin to have prac ti cal ram i fi ca tions that
pre vent them from reach ing their full po ten tial—such as be hav ioral prob‐ 
lems or aca demic per for mance so poor as to pre vent them from ad vanc ing
to the next grade—it may be nec es sary to step in. In gen eral, how ever, otro‐ 
vert kids are at ten tive and well be haved. While they might hold strong opin‐ 
ions and be stub born and will ful in a way un usual for their age, they quickly
learn to mask their de fi ance once they re al ize that their re bel lion is fu tile as
long as adults are in charge.
While otro verts are not nec es sar ily the best stu dents, their in tel lect is ap‐ 
par ent to peers and teach ers alike. More over, the same qual i ties that may be
dis ad van ta geous in the con text of for mal ized school ing will prove to be
great ad van tages once these chil dren grad u ate into the real world.
They are so cially pop u lar, but with only a few close friends or con fi‐ 
dants. Be fore the age of six, it is hard to dis tin guish otro vert chil dren from
their com mu nal peers. They may be more prone to day dream ing, tend not to
ini ti ate ac tiv i ties but rather tag along, and per haps be a bit phys i cally awk‐ 
ward. But be cause otro vert chil dren are friendly, their non-be long ing is not
nec es sar ily ob vi ous to other kids. Some times, the otro vert child’s emo tional
aloof ness in group set tings is baf fling to the rest, who will make ex tra at‐ 
tempts to in vite their re luc tant peer into the fold. The child may tear fully
beg a par ent to stay when be ing dropped off at kinder garten or day care and
typ i cally need much en cour age ment to join in and play with other kids on
the play ground, but these be hav iors are of ten mis at tributed to so cial anx i ety
or shy ness, which is not un com mon in chil dren at tend ing school for the first
time.
As they get older, otro verts’ in dif fer ence to so cial hi er ar chies and dis in‐ 
ter est in the pop u lar ity con tests and cliquish ness that oc cur within friend‐ 
ship groups make them a bit of an enigma to their peers. But while the dis‐ 
tance they put be tween them selves and the col lec tives makes them hard to
know, it also pre vents them from be ing bul lied or ganged up on; wield ing
ex clu sion as a form of con trol or pun ish ment doesn’t work on otro verts, as
they were never mem bers of the group to be gin with. De spite their aver sion
to join ing, the hu mor, in tel li gence, and gen tle de meanor otro vert chil dren
typ i cally dis play make them re spected, well liked, and gen er ally un der stood
to be good com pany.
They are hap pi est when left to their own de vices. That a child can
con tent edly play alone or to gether with one other child for hours and needs
plenty of down time af ter play ing in a group tends to be the first inkling of
the emerg ing otro vert per son al ity. Their per sonal time is vi tal for them—
some thing that well-mean ing adults and peers of ten can not un der stand or
re spect—and how they man age that time is one of the prom i nent traits sep a‐ 
rat ing otro verts from com mu nal peers. Otro vert chil dren are never bored in
their own com pany but can get very bored sur rounded by oth ers, which is
the op po site of how most com mu nal peo ple ex pe ri ence down time. The dif‐ 
fer ence, while life long, is more ob vi ous in child hood, a pe riod when the de‐ 
sire to en gage in group play is thought to be an es sen tial fea ture of “nor‐ 
mal” so cial and emo tional de vel op ment.
They do not want to at tend any or ga nized ac tiv ity. As otro vert chil‐ 
dren get older, they start re fus ing to go to af ter-school clubs, sum mer
camps, class trips (es pe cially overnight trips), and even birth day par ties—
any ac tiv ity that does not al low some respite from the other kids. The feel‐ 
ing of be ing “trapped” with other kids is very dif fi cult for the otro vert child.
In the sec ond decade of life, com mu nal chil dren will rel ish group bond ing
ac tiv i ties; be long ing to a so cial group com prised of other chil dren (“us”) is
a way of es tab lish ing their in de pen dence from the adults in their lives
(“them”). Be cause the feel ing of be long ing is not avail able to the otro vert,
such bond ing ac tiv i ties can be a source of dis com fort. On the other hand,
otro verts don’t ex pe ri ence the sting of re jec tion or ex clu sion the way com‐ 
mu nal chil dren do.
They are un usu ally con sid er ate and gen er ous. The in tense sen si tiv ity
to one-on-one in ter ac tions al lows the otro vert to em pathize with an other
per son in a way that rarely hap pens in ca sual en coun ters with strangers.
Whereas com mu nal chil dren have been so cial ized to see friend ship as a
kind of trans ac tion in which per sonal sac ri fices are re warded with so cial in‐ 
clu sion, the otro vert child does not en gage in the com mon so cial barter of
sac ri fic ing in di vid ual needs for com mu nal ap proval and would there fore
con sider an other’s needs with out feel ing they de serve any thing in re turn.
They are care ful and risk averse. One otro vert I knowre calls how,
when she and her sis ter were chil dren, their par ents would of ten chas tise her
non-otro vert sib ling for suc cumb ing to peer pres sure by ask ing, “If so-and-
so jumped off a bridge, would you do it too?” The otro vert child would not
jump off a bridge just be cause the other kids were jump ing. Be cause otro‐ 
vert chil dren are largely im mune to peer pres sure, they do not en gage in the
kind of risky, reck less, or mis chievous be hav ior that com mu nal chil dren do.
Un con sumed by wor ries about fit ting in, they have the men tal space to con‐ 
sider the con se quences of their ac tions and there fore are not phys i cally ad‐ 
ven tur ous, do not en gage in rough-and-tum ble play, and are care ful not to
get into trou ble.
They do not deal well with change. School of fers chil dren shared but
su per vised time to gether: the per fect set ting for teach ing the un writ ten rules
of func tion ing in a col lec tive. Most chil dren learn these rules quickly and
ef fort lessly and can swiftly ad just their be hav ior when new rules are in tro‐ 
duced and old ones are re placed. But be cause otro vert chil dren don’t have
ac cess to the Blue tooth con nec tion by which these im plicit rules are con‐ 
veyed, the otro vert can not adapt as quickly to this sort of change. This is
why dis rup tions both in their fam ily, such as par ents di vorc ing or the birth
of a child, and in their school ing, such as mov ing to a new school, or even
start ing a new school year with new teach ers and class mates, can be deeply
dis ori ent ing for young otro verts. On the other hand, the otro vert child is a
crea ture of habit who can eas ily ad here to set rou tines and rules as long as
they meet the logic stan dard in the otro vert’s mind.
PAR ENT ING AN OTRO VERT CHILD
Par ent ing an otro vert can be a baf fling en deavor. The first two years of life
are bliss fully re as sur ing as the child de vel ops much like their peers; all the
stan dard par ent ing ad vice is per ti nent, and con ver sa tions with other par ents
sound fa mil iar. Af ter this, the otro vert child starts veer ing into un usual ter ri‐ 
tory. From then on, al most ev ery par ent ing ex pe ri ence is un like most other
peo ple’s, leav ing par ents in creas ingly with out any point of ref er ence other
than their own no tions of what is ex pected. Be hav iors that are not con sid‐ 
ered suf fi ciently “so cial” quickly be come a con stant source of con fu sion
and con cern for the par ents, who have them selves been con di tioned to view
group mem ber ship as the foun da tion of a suc cess ful life.
This is the mo ment at which par ents of otro verts make a de ci sion: do we
ac cept our child as they are, or do we en deavor to mold our child into the
norm? Un der stand ably, given that most peo ple rely on group norms for nav‐ 
i gat ing life, most par ents push their chil dren to be more so cia ble. Sit ting
alone and think ing is in ter preted as friv o lous “day dream ing” and dis cour‐ 
aged. The need for pri vacy be comes “vol un tary iso la tion,” of ten prompt ing
calls from teach ers or school coun selors or even vis its to a ther a pist. Even
the traits so ci ety con sid ers un am bigu ously pos i tive—in tel lec tual cu rios ity,
the ca pac ity for deep per cep tion of the world—are viewed as less im por tant
than ac tive so cial-seek ing be hav ior.
Nat u rally, par ents are con cerned about the so cial prospects of their chil‐ 
dren. Yet ef forts to “fix” an otro vert child are cer tain to back fire, de spite the
par ents’ best in ten tions. Push ing a re luc tant child into the com mu nal ver‐ 
sion of “nor malcy” makes them feel all the more ab nor mal. It amounts to
the par ents (and ev ery one else) telling the otro vert child that there is only
one way to be. This mes sage—that the col lec tive con fers iden tity and that
there is only “one kind of nor mal”—cre ates an im pos si ble dilemma for the
otro vert child. They have no rea son to doubt the adults who tell them—im‐ 
plic itly or ex plic itly—that want ing to be long to a group is “nor mal”; in‐ 
deed, ev ery one around them be haves ac cord ing to this prin ci ple. Yet it does
not com port with their in ner ex pe ri ence.
To ease their par ents’ dis tress, the otro vert child will try to fake it. They
will try to en joy what their peers en joy and sac ri fice their alone time to
prove they are ca pa ble of to geth er ness, but in most cases, their at tempts to
be like the rest will make their sense of oth er ness even more glar ing, if only
to them selves.
Otro vert chil dren who suc ceed in mask ing their dif fer ences are re warded
with pop u lar ity: a uni ver sally de sired so cial achieve ment for com mu nal
chil dren and teenagers. But pop u lar ity and the so cial obli ga tions that ac‐ 
com pany it are suf fo cat ing when one prefers soli tude.
Goad ing otro vert chil dren to be so cially in volved causes them to fight
against their in stincts and over time can lead to anx i ety and de pres sion.
This, in turn, causes par ents to be come even more con cerned, of ten mis at‐ 
tribut ing their dis tress to lone li ness, and a vi cious cy cle en sues.
Once otro ver sion is iden ti fied, par ents should ex er cise “the art of let ting
be.” They should rec og nize that time not spent so cial iz ing with a peer group
is usu ally well spent on in tro spec tion, ex plo ration, and per sonal de vel op‐ 
ment, and that en gag ing with one’s in ner world is no less rich or re ward ing
an ex pe ri ence than en gag ing with the com mu nal one. The otro vert child’s
needs may be dif fer ent from the ma jor ity’s pref er ences. But they are not
wrong; they are just dif fer ent. And par ents should rec og nize that forc ing
their otro vert child into com mu nal ex pe ri ences, like clubs and sum mer
camps, serves only to as suage their own anx i ety at the ex pense of their
child’s emo tional well-be ing.
Giv ing up cer tain con trol is per haps the great est chal lenge for par ents of
any child or teenager. Par ents feel pro tec tive of their off spring, and all chil‐ 
dren need a level of pro tec tive su per vi sion in or der to iden tify and avoid
risk. Par ents also as sume that, by virtue of their more de vel oped brains and
decades of life ex pe ri ence, they know what is best for their still rel a tively
un formed chil dren. So, when it comes to so cial in volve ment, it is un der‐ 
stand ably dif fi cult for par ents to ac cept that their child knows who they are
and what is good for them. Yet, otro verts are in stinc tively aware of their
oth er ness, even if they are too young to ar tic u late it.
Re mem ber that these traits are in nate. Forc ing the otro vert child to join
is there fore not go ing to make them a joiner. It will only cause them un nec‐ 
es sary emo tional dis tress and un nec es sary anx i ety, while se verely strain ing
the par ent-child re la tion ship. In stead, par ents should seek to un der stand and
em brace the essence of non-be long ing and try to en gage their child in ac tiv‐ 
i ties that the child finds pleas ant and con struc tive.
One pa tient of mine who ini tially was very con cerned about her otro vert
child came to un der stand his needs so well af ter our con ver sa tions that she
com pletely changed her ap proach to his so cial life—to the point where she
could some times even see what he needed more clearly than he could. For
ex am ple, when he turned five, he was of course very ex cited about his
birth day and wanted to cel e brate, as he had learned from his com mu nal
peers that birth days are ex cit ing and meant to be cel e brated. How ever, she
knew he would be mis er able if she threw him a birth day party, even though
he was too young to be able to an tic i pate this be ing the case. In stead, she
took him and two other chil dren to the movies—a struc tured ac tiv ity where
they got to sit in the dark and each choose their own candy. He loved it and
was spared the in evitabledis ap point ment and con fu sion of be ing un able to
en joy a mile stone he had been so ex cited to cel e brate.
Here are a few prin ci ples that par ents can use to prac tice the art of let‐ 
ting their otro vert child be:
Ob serve and iden tify what your child is (and isn’t) com fort able
with so cially. Pres sur ing otro vert chil dren into so cial sit u a tions that
dis tress them—un der the as sump tion that they have to try it and then
will “learn to like it”—is un help ful. In stead, find out what makes them
feel good and what doesn’t, and use it as a tem plate for par ent ing. That
is not to say that par ents need to al ways ac qui esce to their child’s pref‐ 
er ences, but rather that those pref er ences should be known and al ways
be con sid ered.
En cour age one-on-one friend ships. For most chil dren, friend ship
groups of fer a sense of safety, be long ing, and sup port. When so cial iz‐ 
ing with these groups, most chil dren switch to a uni fied state of mind
where the bound aries be tween the self and the col lec tive are blurred.
But otro vert chil dren are not able to see them selves or oth ers as any‐ 
thing other than dis crete in di vid u als, de tached from the col lec tive. This
is why they pre fer one-on-one friend ships and find group ac tiv i ties
both lonely and bor ing, even when the group is en gag ing in ac tiv i ties
that they would oth er wise en joy. Rather than forc ing otro vert chil dren
to play or so cial ize in large groups in the hope that friend ships will de‐ 
velop, par ents should en cour age and pro vide op por tu ni ties for their
child to forge friend ships with just one or two peers at a time.
Learn to en joy their spe cial traits. What par ent wouldn’t want their
child to be re spon si ble, risk averse, and emo tion ally self-re liant? Re‐ 
mem ber that be cause otro vert chil dren are not sus cep ti ble to peer pres‐ 
sure, they are ret i cent to en gage in child hood mis chief and can be
trusted to avoid the risky be hav iors most chil dren try, even when un su‐ 
per vised. It’s tempt ing for a par ent to let those ben e fi cial traits be
dwarfed by con cerns about their child spend ing time alone. In a
strange (but very typ i cal) twist, these par ents find them selves urg ing
the child to be more ad ven tur ous and to take more risks. In stead, fo cus
on the up side.
Trust their in stincts. Even at a very young age, otro vert chil dren
know what they want. Be cause they know them selves, they of ten
choose the best course for them selves. It is of ten coun ter in tu itive to
trust the in stincts and wishes of a young child, and ob vi ously, par ents
need not sim ply in dulge all their child’s likes or dis likes. But it is also
im por tant to re mem ber that an otro vert child can be trusted to act in
their own best in ter est, even if they are re luc tant to con sult their par‐ 
ents or ask for their ad vice. When par ents of otro verts think back on
their child’s early years, they of ten re al ize that their child knew in‐ 
stinc tively what they needed and what was good for them. Let them
fol low these in stincts—within rea son, of course—even when most
other kids move in a dif fer ent di rec tion.
Help them cre ate spe cial mem o ries. Otro vert chil dren do not form
shared mem o ries. A class trip, for ex am ple, is re mem bered from the
sin gu lar point of view. With out col lec tive mem ory to lean on, otro verts
are the sole cus to dian of their rec ol lec tions. Later on in life, when they
be come aware of that trait, they will be come more in ten tional about
what kind of mem o ries they make for them selves, but un til then par‐ 
ents can play a role in help ing them make ev ery day life wor thy of re‐ 
mem ber ing. When my chil dren were younger, any time I saw some‐ 
thing in ter est ing or beau ti ful on our walks to gether, I would re mind
them to pay at ten tion, as they were “work ing on cre at ing their child‐ 
hood mem o ries.” This ad vice doesn’t ap ply to just otro vert chil dren.
Many chil dren for get so many spe cial mo ments of their child hood be‐ 
cause chil dren do not yet know to look at the world as a source of fu‐ 
ture mem o ries. So, it is of ten up to the par ent to help their child cu rate
what will later be come cher ished mem o ries.
Early de tec tion of otro vert ten den cies can be highly ben e fi cial to chil‐ 
dren, mak ing it eas ier for them to sort them selves out ahead of the crush ing
wave of ado les cence, which is vi tal to cross ing the dif fi cult teenage years
un scathed. All that is needed is an aware ness of otro ver sion and a will ing‐ 
ness to em brace its traits in a unique child.
16
Run ning the Gaunt let of Ado les cence
There is no more chal leng ing time for otro verts than ado les cence, a pe riod
when ev ery teenager around them, re gard less of so cial po si tion, is vy ing for
mem ber ship in a peer group. In a way, an ado les cent group is a cult, closed
off to non mem bers and ruled by the col lec tive ethos, which re quires un bri‐ 
dled fealty.
For com mu nal peo ple, ado les cence is a time for fig ur ing out what type
of per son they are be com ing; it’s the pe riod when, aided by a new found
sense of in de pen dence, they be gin to sep a rate their per son al i ties, val ues,
and pref er ences from those of their par ents.
Para dox i cally, the so cial sort ing that oc curs dur ing this pe riod ends up
be com ing the pri mary mech a nism through which the teenager’s nascent
sense of self de vel ops. The sense of us ver sus them be comes part of the
teenager’s iden tity, along with what ever im age the group chooses to project,
what ever rules the group de cides to fol low, and what ever ideas the group
de cides to be lieve in or care about. It is in many ways a grand re hearsal for
adult hood, where most peo ple iden tify strongly with the groups they be long
to.
Yet ado les cence is unique in that these group ings are largely ar bi trary, in
that the group mem bers don’t re ally share any thing other than be ing the
same age and at tend ing the same school. In a way, an ado les cent group is a
ran dom col lec tion of teenagers put in daily con tact. Over time, friend ship
groups may co a lesce around shared ac tiv i ties—the soc cer play ers, the
drama club kids, the bud ding mu si cians, and so on—but even these cliques
are more a mat ter of prox im ity and con ve nience than true kin ship. In some
cases, ado les cents who choose to par tic i pate in sim i lar ac tiv i ties share sim i‐ 
lar cu riosi ties or in ter ests but are just as likely to be par tic i pat ing for less in‐ 
trin sic rea sons, such as think ing ahead to what will look good on their col‐ 
lege ap pli ca tions, or be cause their par ents en rolled them. For teenagers, the
group mem ber ship it self is enough to cre ate a sense of kin ship and unite its
mem bers, whereas adults need a shared be lief, in ter est, or cul tural same ness
to co here around.
There is no ques tion that the teenage years are the most bruis ing pe riod
for otro verts. For the first time, not be long ing is painful. Trapped be tween
their nat u ral ret i cence and the so cial struc tures im posed on them, otro verts
dis cover that be ing them selves and be ing a teenager are fun da men tally in‐ 
com pat i ble. In ado les cence, the group as signs one’s so cial po si tion, whether
one likes it or not; never be fore or af ter do peers have such power over a
per son. Most teenagers un ques tion ably ac cept the group’s rule even if it is
un fa vor able to them. But for otro vert teenagers, the group plays a con tra dic‐ 
tory role. On one hand, it holds no real au thor ity; on the other, it is “the
only game in town.” Short, per haps, of be ing home schooled, it is vir tu ally
im pos si ble for one to opt out. The need to fake fealty to the hive mind goes
against the otro vert’s in stincts, and it is the first time they strongly feel their
oth er ness since ev ery one around them is con sumed with the en deavorof fit‐ 
ting in, join ing, and be ing liked.
This pres sure to mask their dis com fort, com bined with the teenage hor‐ 
monal storm, is of ten what can turn meek rebels into reck less pseudo ex tro‐ 
verts. Such a dras tic be hav ioral re ver sal is not nat u ral or com fort able to
otro verts. Their in ner au then tic core con tin ues to ad vo cate meek ness, even
if they go to great lengths to erect a false “bad kid” fa cade.
In the nor mal or der of things, teenage boys need to be loud and bois ter‐ 
ous to be con sid ered “so cially suc cess ful,” whereas so cial suc cess for
teenage girls de pends on seem ing con fi dent. The re bel lious streak in ado les‐ 
cence is highly val ued for both gen ders, and the big gest risk-tak ers gen er‐ 
ally emerge as the nat u ral lead ers to the throng of in se cure teenagers. Over
time, the ex haust ing work of main tain ing a so cial im age based on pre tense
ex acts a high psy cho log i cal price. Be ing wild and bois ter ous is so un nat u ral
and dif fi cult that some otro vert teenagers start us ing drugs and al co hol to
loosen up and make their pseudo-ex tro vert per for mance more tol er a ble.
Such was the case for M, a woman in her early twen ties who was re‐ 
ferred to me by her god mother, a pre vi ous pa tient of mine. She walked into
the of fice al most thirty min utes late and vis i bly drunk, slur ring her words
and nearly tip ping over. She sat on the couch, bleary eyed, her eye makeup
smeared on her face in long black lines from cry ing. She said hello and then
she fell asleep, slumped to the side.
M was very priv i leged. Her par ents were rich and fa mous with houses
and man sions all over the world, along with yachts, pri vate planes, and
mem ber ships at ex clu sive pri vate clubs, and they sent M to the best pri vate
school money could buy. But this wasn’t a case of ab sent par ents pam per ing
their child with lux ury to com pen sate for emo tional ne glect; as the only
daugh ter in the fam ily, she was show ered with love and at ten tion. In speak‐ 
ing with her fam ily, I learned that M had been a beau ti ful girl who grew up
to be a lovely teenager, with a fetch ing, self-as sured de meanor that at tracted
ro man tic at ten tion from boys and adu la tion from girls. She was an ex cel lent
stu dent and liked to surf, ski, and ride horses, all of which she did with per‐ 
fect ease.
Then, around the age of four teen, she started to change. She be came ir ri‐ 
ta ble and moody, of ten shout ing at her par ents and teach ers. She started en‐ 
gag ing in risky be hav iors and be came, as she de scribed her self to me, rather
harshly, “a drug ad dict and a whore.” The change was so abrupt that she
was in dire straits be fore any one could come to terms with what was hap‐ 
pen ing. She had an abor tion, started cut ting her wrists, and dis ap peared for
days with out com mu ni ca tion, only to re turn drunk and in ex pli ca bly bruised.
She saw some of the most renowned ado les cent ther a pists, started on med i‐ 
ca tion, and was sent to at tend wilder ness pro grams and board ing schools
where it was hoped that she would build char ac ter and re ceive dis ci pline,
but these in ter ven tions seemed to only in crease her rage, frus tra tion, and
act ing out.
She re ceived sev eral di ag noses, in clud ing bipo lar dis or der and bor der‐ 
line per son al ity dis or der, and was treated by spe cial ists in those fields. As
soon as she be came eman ci pated, she started split ting her time be tween
New York and Los An ge les, where she was wel comed by the young, hip
celebrity crowd. Her no to ri ety grew; she was known as the wildest among
the wild ones. This was when I met her. At age twenty-three, she was al‐ 
ready spent and hope less.
Af ter that first ses sion when she passed out in my of fice, M and I con‐ 
nected well, and it wasn’t long be fore her prickly and bored at ti tude gave
way to a warm, thought ful, and re spect ful one. She did not change the tenor
of her be hav ior out side the of fice and con tin ued to lead a well-pub li cized
life of par ty ing, de bauch ery, and drunk en ness. But in our con ver sa tions,
dur ing which she was able to let down her care free fa cade, the nar ra tive
evolv ing was one of sad ness, empti ness, and de spair. This is not un usual
among some of the fa mous peo ple I’ve worked with whose pub lic im age is
very dif fer ent from their pri vate self. In my ex pe ri ence, how ever, most of
these peo ple en joy their so cial po si tion. They get their sense of self-worth
from the out side, from all the ador ing peo ple around them, and so they
make an ef fort to pre serve their false per sona in the pub lic eye.
But in M’s case, some thing was dif fer ent. She dis dained all the peo ple
sur round ing her, and de tested her no to ri ety. She se cretly hated all those par‐ 
ties and pre ferred stay ing home with her dog and paint ing. She loved do ing
other things, too, but none of them seemed to com port with the way she was
liv ing her life. The only time she truly felt like her self, she told me, was
when she was alone; the minute she left the house, or her posse came to her
place, or a new man pur sued her, she be came a dif fer ent per son. The al co‐ 
hol fa cil i tated her wild pub lic be hav ior, but ul ti mately, it was she who made
the bad de ci sions.
M wasn’t bipo lar, sui ci dal, or an al co holic; she was an otro vert. As a
child, she had reigned ef fort lessly as the queen of the so cial uni verse, but
ev ery thing changed at the on set of pu berty, when her friends be gan to close
ranks and form a co he sive, ex clu sive group that ex isted out side the at ten‐ 
tion of the adults. M was un able to truly feel part of the group, even as she
was queen. What seemed ex cit ing or im por tant to the rest left her cold, and
she could not un der stand why. She had ev ery rea son to be en joy ing her life.
Her child hood had been happy, she had ev ery ma te rial good a per son could
imag ine, and ev ery one wanted to be her friend. But de spite liv ing what
many would con sider a charmed life, M was deeply un happy, and she
couldn’t fig ure out why.
Ashamed for feel ing so dis con nected from the group, she de cided her
only op tion was to fake it. She wanted to stay home and be alone, to dis ap‐ 
pear, rather than be pop u lar and fa mous, but that seemed un grate ful. Hav ing
been given so much just for be ing born, she felt re quired to play out the role
that life had seem ingly cast her in. She had a friend who was very un pop u‐ 
lar but didn’t seem to care about it, and M was jeal ous of that abil ity.
Those con flicts were quickly re solved—in her mind, at least—when M
dis cov ered al co hol. When she drank, all her dis com fort, in hi bi tions, and
meek ness went away. She be came the row di est, most out ra geous per son in
the room, which made her feel “nor mal,” but she was not her self. She came
to see that she had worn her self down try ing to force her self into no to ri ety
she did not want in the first place—that it was her cir cum stances that dic‐ 
tated she should be a so cial su per star, rather than her own de sire. Worse,
she needed al co hol to sus tain the cha rade.
With recog ni tion that she was an otro vert, ev ery thing clicked into place,
mo ti vat ing her to be come sober, then to cut ties with the worst syco phants,
who would drag her to par ties and bring her drugs. She leaned into her love
of an i mals and be gan work ing in an i mal shel ters be fore even tu ally buy ing
and mov ing to a farm to start an an i mal sanc tu ary.
M’s story high lights one way that be ing a mis un der stood otro vert teen
can play out, par tic u larly when the teen has been egged on by the adults and
peers around them. But not all ado les cent otro verts are self-de struc tive—at
least not in the sense of en gag ing in risky be hav iors. In fact, many have a
very dif fer ent ex pe ri ence.
In gen eral, otro verts—both male and fe male—feel verytime try ing to be long. Yet, for them, at tempts to con form, be an in‐ 
sider, and ex pe ri ence to geth er ness is fu tile. They are not com mu nal peo ple
and there fore can not truly feel like a mem ber of a group even if in vited and
en cour aged. Nor do they want to.
And therein lies one of the great est ben e fits of be ing an otro vert: once
you ac cept and un der stand who you are, you be come free from the tremen‐ 
dous so cial pres sures that group mem ber ship im poses. When you have no
affin ity for any par tic u lar group, your sense of self-worth is not con di tioned
on the group’s ap proval. You are not ob li gated to en dorse the col lec tive po‐ 
si tion, opin ion, or point of view. You get to en joy close ness and con nec tion
in in di vid ual re la tion ships, while be ing ex empt from the so cial con tract that
re quires you to pri or i tize “the good of the group” and ful fill so cial needs
over per sonal ones. You learn how to sep a rate what you in her ently know to
be true from what you were in doc tri nated to ac cept as true. And, best of all,
you know no other way to think other than to think for your self.
That’s what this book is all about. It aims to de scribe and ex plain the
great free dom and ful fill ment that come from liv ing life off the com mu nal
grid, while also high light ing the out size value that the otro vert per spec tive
con trib utes to the world. Al though con ven tional wis dom is nec es sary for
sta bil ity, rev o lu tion ary ideas are cru cial to progress, so we must learn to tol‐ 
er ate them rather than shut them away. As Freud said, “It re mains a fact, in‐ 
deed, that great de ci sions in the realm of thought and mo men tous dis cov er‐ 
ies and so lu tions of prob lems are pos si ble only to an in di vid ual work ing in
soli tude.”
Over the years of my work with my pa tients, I’ve be come in creas ingly
aware of how be ing an otro vert my self has shaped my ther a peu tic phi los o‐ 
phy and, in turn, my abil ity to help my pa tients. I value what most seem to
ig nore—the right we all have to de fine our selves. When you dis cover your
own self again af ter years of defin ing your self by the group to which you
be lieve you should be long, you get to ap pre ci ate your pri macy in your own
life and your duty to take care of your self. There is noth ing more free ing
than to re al ize that since you can not be any thing other than your self, it
makes very good sense to like and value that per son.
As you learn about the qual i ties of otro verts and their unique way of be‐ 
ing in the world, you may re al ize that you are an otro vert, or that peo ple in
your life, per haps very close ones, are otro verts.
But whether or not you rec og nize your self or some one you know in
these pages, I hope it will help you see how the otro vert ex pe ri ence can en‐ 
rich the col lec tive con ven tional wis dom about how to ex ist in the world.
Whether or not you are an otro vert, your most en dur ing re la tion ship is that
be tween you and your self. By strength en ing that re la tion ship, you can also
ac cess the men tal space and en ergy to know and con nect with oth ers more
deeply, and on your own terms.
Sub mit ting your life to the group for re view in evitably leads to the re lin‐ 
quish ing of con trol over your own hap pi ness. As philoso pher Friedrich Ni‐ 
et zsche wrote, “Free dom is the will to be re spon si ble for our selves.” It is
my hope that this book will help you claim your in ner free dom.
PART I
THE FOUN DA TIONS OF NON-BE‐ 
LONG ING
1
What Is an Otro vert?
Otro vert
[noun, ad jec tive ot-truh-vert; verb ot-truh-vert] An “otro vert” em bod ies the
per son al ity trait of non-be long ing: re main ing an eter nal out sider in a com‐ 
mu nal world. Un like those with re la tional dis or ders, otro verts are em pa‐ 
thetic and friendly, yet strug gle to truly be long in so cial groups, de spite no
ap par ent be hav ioral dis tinc tions from well-ad justed in di vid u als.
“I can’t ex plain it. He is a sweet heart. A beau ti ful boy in side and out, and so
bril liant.” This was how a ses sion with N, a long time pa tient of mine, be gan
some years ago. In stead of talk ing about her self, she wanted to talk about
her son, A. He was a fresh man in high school, and in spite of com ing from a
warm, lov ing fam ily with at ten tive par ents, he’d started hav ing so cial dif fi‐ 
cul ties dur ing the last year of mid dle school. But his is sues were of a kind
his mother had never re ally heard of or seen. He wasn’t be ing bul lied or left
out or made un com fort able by peer pres sure—the usual is sues at that age.
In fact, she said, “he’s happy go ing to school and gets straight As. Ev ery one
loves him, and he gets in vited to all the par ties but mostly doesn’t go.”
He wasn’t de pressed or anx ious and had sev eral close friends, if not a
big so cial group. But he turned down al most ev ery in vi ta tion for so cial
gath er ings and trips and she couldn’t un der stand why. “For a teenager, he’s
not moody or an gry,” she re flected. “But he is so closed off. I never know
what he thinks, and he won’t dis cuss why he doesn’t want to go away to
camp with his friends, who keep invit ing him. The fact that he doesn’t seem
to care that he might be be ing left be hind so cially makes me wor ried the
most. How can it be that at the age of four teen, he has no in ter est in join ing
in with the other boys?”
I had seen this be fore. No par ent likes to watch their child strug gle so‐ 
cially—a con cern that be comes even more pro nounced in pu berty, when be‐ 
ing ex cluded has se vere ef fects on mood, sense of well-be ing, and even
abil ity to func tion. But N added a twist to that. She was not wor ried that A
was un pop u lar. She was wor ried that he was some how fun da men tally dif‐ 
fer ent from the rest, in spite of the fact that he was an in tel li gent and in
many ways pre co cious kid: “I re call when he was four, his pe di a tri cian’s
nurse con fessed that she found her self want ing to share her life’s dif fi cul ties
with him, only to catch her self at the last mo ment,” she told me. And this
nurse wasn’t the only one; other adults—rel a tives, fam ily friends, and even
teach ers—also found them selves want ing to con fide in him, for get ting he
was so young. “My mother is con vinced he’s an em path—what ever that
means. But I don’t want him to be spe cial. I want him to be a reg u lar
teenager.” N’s voice broke as she spoke. “And not car ing about your so cial
life at this age is not nor mal,” she said.
I agreed that his in dif fer ent at ti tude to what his peers con sid ered great
fun was un usual but re as sured her that it didn’t sound like a psy chi atric con‐ 
di tion to me. I asked if A had a ther a pist and whether he’d done neu ropsy‐ 
cho log i cal test ing. Yes, to both, she said. “His test ing showed high in tel li‐ 
gence, emo tional ma tu rity, and no cog ni tive is sues. The ther a pist said that
he is an enigma to her, which does not give me great con fi dence.”
Three weeks later, I sat with A in my of fice. He en tered shyly, as would
be ex pected from a four teen-year-old. He was hand some, ca su ally dressed,
charm ing, and calm. I said, “Your mother is wor ried that you have no
FOMO,” and we both chuck led be fore he said earnestly, “You have FOMO
when you fear miss ing out. But if you know you are not miss ing out, there
is no fear.” I wanted to bet ter un der stand his way of see ing things and asked
him to de scribe his ex pe ri ence of at tend ing par ties and other so cial events.
“I just feel weird,” he said, “like I’m not part of it, which is odd as these are
all my friends. I know they like me and are happy I’m there, but I still don’t
feel con nected. I feel lonely or bored only when I am with many peo ple,
and not when I’m with one or two close friends or when I’m alone.” Then
he added, clearly frus trated, “I don’t like to say those things be cause it
makes me sound likecon flicted about
at tract ing at ten tion to them selves. Risk-tak ing to im press the group feels
silly and self-de struc tive, so in stead of be ing reck less, most teenage otro‐ 
verts sim ply at tempt to blend in. But at tempts at con form ity—at sac ri fic ing
the self for the sake of fit ting in—come no more nat u rally to the otro vert
than does the cha rade of pseudo ex tro ver sion. Pre tend ing to be in ter ested in
what they find bor ing and feign ing ex cite ment with the rest about things
they couldn’t care less about take a big toll on the otro vert. And keep ing up
this per for mance has only be come more tax ing in re cent years, as the level
of ex po sure and con stant pres ence teens are ex pected to main tain on so cial
me dia and the in ter net pre vents the teenage otro vert from find ing respite.
To day, as the mother of one twelve-year-old otro vert put it to me, her
daugh ter can not sim ply (and un truth fully) de clare her love of Tay lor Swift
and con sider the mat ter set tled; to keep up the cha rade, she must quote Tay‐ 
lor’s lyrics in her text threads and post to so cial me dia about how many
hours she spent on line try ing to pro cure con cert tick ets. In gen eral, the fact
that ado les cent life is con ducted largely on pub lic so cial me dia plat forms
only ex ac er bates teenage otro verts’ vul ner a bil ity: it is the only time in their
life they envy the rest and loathe how dif fi cult it is to be them selves.
It is cru cial that par ents iden tify the otro vert trait in their teenager and
make them selves aware of the chal lenges this en tails. Tell tale signs might
in clude the fol low ing:
Dis in ter est in teenage drama, pop u lar ity con tents, or gos sip
Feel ings of in ad e quacy or oth er ness that seem in com pat i ble with their
so cial sta tus or how they ap pear to oth ers
Sud denly adopt ing a hy per ex tro verted per sona (in real-life in ter ac tions
and on so cial me dia) that is not their own
Re luc tance to at tend par ties or cel e brate rites of pas sage such as bar
and bat mitz vahs, quinceañeras, or grad u a tions
Dress ing very dif fer ently, lis ten ing to dif fer ent kinds of mu sic, and
show ing in ter est in dif fer ent kinds of ac tiv i ties com pared with their
peers
Re fusal to par tic i pate in team sports, es pe cially if the teen showed an
in ter est in ath leti cism as a child
The de sire for more alone time (even if they do not in dulge that de‐ 
sire); so cial iz ing with friends one-on-one rather than in groups
Prag ma tism, a lack of ad ven tur ous ness, and an adult like abil ity to as‐ 
sess risk
Dis play ing a few of these qual i ties does not nec es sar ily mean that your
teenager is an otro vert. But dis play ing most or all of these traits is a sign
that a teen may be go ing through life feel ing like a per pet ual out sider. If this
is the case, it’s im por tant to ap proach the teenage otro vert in a way that
won’t trig ger their in ner re bel lion—to think of a teenage otro vert as a
teenager first and an otro vert sec ond. Par ents should avoid com ments that
will trig ger the feel ings of con fu sion, shame, and alien ation that come from
feel ing mis aligned with the group’s tra jec tory, and in stead point out the dif‐ 
fer ence in im por tance that the otro vert as signs to cer tain as pects of teenage
life rel a tive to oth ers. Even if their at tempts at broach ing a dis cus sion are
re jected at first, it’s vi tal that par ents do all they can to help their otro vert
teen un der stand and make room for this facet of who they are.
If a teen can tra verse the gaunt let of ado les cence un scathed, they emerge
want ing to never be any one else. How they nav i gate these years can make
the dif fer ence be tween a rich life spent en gaged in what they en joy and are
good at and a life com pro mised by the pur suit of im pos si ble goals and
many re grets.
Ex tolling a life of in di vid u al ism to a mem ber of the most con form ist age
group can alarm them and cause re treat; even tu ally, how ever, most otro vert
teens will out grow the feel ings of in ad e quacy and weird ness they ex pe ri‐ 
ence in the group, free ing up men tal space to un der stand and em brace their
dif fer ences, and live life more au then ti cally and fully.
17
Ro man tic Re la tion ships
Recently, an otro vert in her late thir ties whom we’ll call R con fided in me
that she was strug gling in her love life. She des per ately wanted to get mar‐ 
ried and had been on line dat ing for a num ber of years, wholly un suc cess‐ 
fully. Then she came right out and asked me, “Will I ever be able to forge a
deep ro man tic re la tion ship with a com mu nal per son, or am I only ever go‐ 
ing to be com pat i ble with other non join ers like me?”
The fact that otro verts are sig nif i cantly un der rep re sented in our plu ral ist
so ci ety makes the pos si bil ity of meet ing an otro vert part ner rel a tively low.
Since otro verts strug gle with be ing out in pub lic, they are most likely to
meet a ro man tic part ner by chance or on line than at a party or within the
walls of a crowded bar. These dif fi cul ties are only am pli fied by the fact that
dur ing the years when peo ple typ i cally be come in ter ested in courtship, most
otro verts don’t un der stand their non-be long ing, feel in fe rior to be longers,
and strug gle un suc cess fully to be like the rest.
But once an otro vert emerges from the gaunt let of ado les cence with a
bet ter sense of who they are, it be comes much eas ier to find a ro man tic
part ner who shares their view of the world—and when they do, they can
quickly forge a strong bond. Af ter all, otro verts are keen ob servers and em‐ 
paths. More over, in a com mit ted, long-term ro man tic re la tion ship, it is all
but im pos si ble for the otro vert to suc cess fully mask their non-be long ing; in
time, their fa cade will crum ble, al low ing them to show up au then ti cally as
who they are.
When both part ners are otro verts, they re spect each other’s bound aries
and base their re la tion ship on mu tual un der stand ing rather than so cial con‐ 
ven tions. Be ing highly at tuned to other in di vid u als—as well as them selves
—otro vert cou ples are close to each other with out be ing en meshed. They
cre ate a covenant of mu tual re spect, ce mented by their strong in ner re bel‐ 
lion against so cial con ven tions. They also tend to be very loyal and pro tec‐ 
tive of each other and do not feel jeal ous of or threat ened by the other’s ac‐ 
com plish ments. As equally un con ven tional thinkers, they show a keen in‐ 
ter est in oth ers’ imag i na tive ideas and orig i nal thoughts. That stim u lates a
unique dy namic in which cre ativ ity and rein ven tion are es sen tial to the
func tion ing of their unit.
Most cou ples are a union of two peo ple who en ter the re la tion ship with
dis tinct so cial and cul tural iden ti ties that color how they un der stand—or
more of ten mis un der stand—each other. Think, for ex am ple, about cou ples
in which one per son is a de vout Catholic and the other is an athe ist, or in
which one per son grew up as a mem ber of the 1 per cent while the other
lived pay check to pay check. In com mu nal cou ples, these dif fer ences are so
cen tral to the iden tity of each per son that they can be come a re cur ring
source of con flict and com pli ca tions. The otro vert cou ple is un en cum bered
by such bag gage. Even if the two come from very dif fer ent re li gious back‐ 
grounds, so cial classes, eth nic i ties, and so forth, they feel lit tle con nec tion
or al le giance to them. As a re sult, the chance of these dif fer ences caus ing
con flict or fric tion is van ish ingly low.
Ob vi ously, otro vert cou ples fight like ev ery other cou ple and are not im‐ 
mune to dis agree ments about petty things. But when it comes to the big
things—like child-rear ing, fam ily obli ga tions, and how to man age their so‐ 
cial lives—dif fer ences of opin ionare rare, and gen er ally a mat ter of de gree:
what is seen as a nec es sary so cial obli ga tion to one may not be deemed nec‐ 
es sary by the other, for ex am ple. Be cause they are out wardly ac com mo dat‐ 
ing by na ture, they can be con vinced to re con sider a strongly held po si tion
that is in di rect con flict with their part ner’s. It is eas ier for an otro vert to be
part of an otro vert cou ple for mainly one rea son: it max i mizes the chances
that both part ners in nately un der stand what com mu nal peo ple can not—
what life as a non-be longer is like.
Which brings us back to the ques tion R posed to me: can an otro vert
forge a suc cess ful, last ing ro man tic part ner ship with some one who is not an
otro vert? It is ini tially hard for be longers to un der stand non-be longers and
vice versa, so it makes sense that hav ing two very dif fer ent ways of see ing
the world could pro duce a va ri ety of mu tual mis un der stand ings. Early on in
the re la tion ship, the in tense re sis tance to cer tain things most con sider ne go‐ 
tiable, dis in ter est in things uni ver sally con sid ered “fun,” and un shak able in‐ 
ner con vic tion (some might say stub born ness) in some one who oth er wise
comes across as very ac com mo dat ing and con sid er ate can be baf fling to the
non-otro vert part ner. As the re la tion ship de vel ops, the otro vert’s cer tain
aloof ness, re sis tance to tra di tions and so cial gath er ings, and awk ward ness
in group set tings can be frus trat ing—es pe cially if the part ner is highly so‐ 
cial, has a huge fam ily that loves to gather for hol i days, or has a job that re‐ 
quires them to at tend many func tions they are em bar rassed to al ways at tend
solo. And so most “mixed” cou ples—otro verts and com mu nal peo ple—
need to work harder to be suc cess ful. But that is not at all a bad thing!
In com pat i bil i ties of all kinds pose great op por tu ni ties for all cou ples to
learn about each other; while they may have to in vest more ef fort into seek‐ 
ing com pro mises and un der stand ing, this in vest ment pays div i dends in the
form of more in ti mate, deeper bonds. Be yond the ini tial “get ting to know
you” pe riod, most com mu nal cou ples in vest very lit tle time or ef fort in
deep en ing their un der stand ing of each other, as sum ing that at some point
over the course of their lives to gether, they will be able to find com mon
ground. When you stop to think about it, the idea of liv ing with some one
you met as a stranger for the rest of your life is mind-bog glingly odd. Noth‐ 
ing pre pares us for it, and the no tion that any two peo ple will view the
world through iden ti cal lenses is an in sult to ev ery thing we know about hu‐ 
man con scious ness. Yet most peo ple don’t lis ten to each other with deep in‐ 
ter est and em pa thy, and gen uine at tempts to see things from a part ner’s per‐ 
spec tive are rare and un ex pected.
This is where the mixed otro vert and com mu nal cou ple shines. The dif‐ 
fer ences be tween a com mu nal per son and an otro vert are more ap par ent and
show up ear lier than other dif fer ences be tween ro man tic part ners. Again,
this fric tion is a good thing: it al lows the cou ple to con sider their dif fer‐ 
ences early on. Mean while, hav ing a part ner who is will ing and able to take
on the lion’s share of the small talk at un avoid able com mu nal gath er ings, or
who has a large cir cle of friends to go out with, leav ing the other per son to
en joy their alone time, can be a huge source of re lief for the otro vert—and
these things are rarely a source of con flict when ex pec ta tions are set near
the start.
No mat ter how hard they try, otro vert part ners es pe cially are un likely to
learn to love (or even get used to) some com mu nal as pects of life with the
pas sage of time. Be ing an otro vert is not some thing we grow out of—nor
should we want it to be. Once a com mu nal part ner can un der stand the
salient as pects of the non-be longer, they can share in close ness with out
code pen dency. Gain ing em pa thy with out judg ment of each other’s needs
paves the way to any num ber of so lu tions.
For ex am ple, an otro vert mar ried to a so cial per son un der stands that
their spouse has the need to go to par ties or other so cial events like group
trips, while they feel per fectly con tent to be ex cluded from their part ner’s
rich so cial life. And so it is quite easy to come to a mu tual un der stand ing
that the so cial spouse will do these things alone, with no re sent ment on ei‐ 
ther side. Or, if one per son in the re la tion ship likes to do din ners with other
cou ples, they can limit it to one other cou ple at a time rather than many.
One otro vert de scribed to me how, when she and her hus band go out
with friends, there’s al ways a pre de ter mined exit time and strat egy, with an
ex cuse queued up in case the friends want to ex tend the evening. Know ing
that there’s an agreed-upon de par ture time al le vi ates her anx i ety about the
evening stretch ing on for longer than she can bear and al lows him to en joy
the com pany of friends with out hav ing to worry that she has ex ceeded her
thresh old and is silently des per ate to leave. When a sac ri fice is un avoid able,
the mu tual un der stand ing that nei ther part ner’s pref er ence is any more or
less jus ti fied al lows the cou ple to reach a fair com pro mise.
Otro verts also bring some thing ex tra to re la tion ships. Here are a few
ben e fits of pair ing off ro man ti cally with an otro vert.
They put their part ner first. The hive views any cou ple as one node in
its so cial net work, which also in cludes fam ily, friends, neigh bors, and co‐ 
work ers, who are of ten con sid ered le git i mate com peti tors for a cou ple’s at‐ 
ten tion to each other. Otro verts don’t pri or i tize the col lec tive this way. They
are very present for their sig nif i cant other and deeply in vested in fam ily
life, which they pri or i tize over their ca reers and other so cially sanc tioned
no tions of suc cess.
They have an in nate ca pac ity for in ti macy. Through out our lives, we
re ceive im plicit in struc tions and train ing on how to be have within the col‐ 
lec tive, but no one tells us how to live as a cou ple. The so cial skills a com‐ 
mu nal per son pos sesses aren’t the same as the skills needed for a suc cess ful
in ti mate re la tion ship, and vice versa. What ever an otro vert may lack in the
so cial skills de part ment, they com pen sate for by be ing highly skilled in fos‐ 
ter ing in ti macy.
They don’t try to fit the re la tion ship into the com mu nal mold. Otro‐ 
verts un der stand that what is good for one re la tion ship will not nec es sary be
good for an other; in fact, at tempts to model one’s re la tion ship on that of an‐ 
other cou ple or on what so ci ety tells us healthy re la tion ships should look
like is a big rea son so many mar riages are un happy. The otro vert’s abil ity to
know what feels right with out look ing to oth ers for guid ance is in valu able
in all re la tion ships, ro man tic or oth er wise.
In short, otro verts like R should not de spair. As an otro vert, you do not
need to be un der stood so much as ac cepted by your part ner in or der to cre‐ 
ate a won der ful, com ple men tary, and long-last ing bond.
18
Otro verts at Work
In adult hood, the otro vert can choose how to run their life, es pe cially in
terms of which re la tion ships to cul ti vate (or not) and how they spend their
leisure time. But while it may be rel a tively easy to opt out of re la tion ships
or ac tiv i ties that do not serve them, the one as pect of com mu nal life that
most otro verts (and other healthy adults) can not avoid is work. The fact that
many jobs re quire some de gree of col lab o ra tion, con sen sus, and par tic i pa‐ 
tion in com mu nal rit u als—from at tend ing of fice hol i day par ties to nav i gat‐ 
ing the pol i tics of small talk—means that workis of ten the big gest chal‐ 
lenge to the otro vert’s silent re bel lious ness. But it doesn’t have to be, as
long as the otro vert has stopped to care fully con sider what kind of work en‐ 
vi ron ment they need and what they are good at.
The en vi ron ments that most peo ple seem to tol er ate—or even thrive in
—are im pos si ble for otro verts. Pro fes sions that al low work to be done col‐ 
lab o ra tively—such as pi lot, teacher, or re searcher—are so tax ing for the
otro vert that very lit tle en ergy is left for ac tu ally do ing the work. Whereas
team work, to geth er ness, and col lab o ra tion are stress ful, a pro fes sion that al‐ 
lows one to work in de pen dently—as a con sul tant, a writer, a pho tog ra pher,
a solo preneur, or an in de pen dent con trac tor, for ex am ple—will likely be a
good match for the otro vert. It does not have to be a high-pow ered or pres ti‐ 
gious job so long as there is an op por tu nity for self-gen er ated de ci sions and
the free dom to come up with ideas that do not con form to the con sen sus.
My pa tient D was a hu man re sources man ager in a big com pany when
she came to see me in des per a tion. She was very tal ented and suc cess ful but
kept chang ing jobs fre quently. The pat tern was al ways the same. She’d start
a new job with great en ergy, brim ming with ideas, con nect ing eas ily with
her co work ers, and feel ing that she’d found, at last, the place where she
could set tle down. Sooner or later, how ever, she started ex pe ri enc ing a
grow ing emo tional fa tigue, fol lowed by de pres sion and over whelm so se‐ 
vere that she strug gled to at tend even the most rou tine meet ings. She
dreaded Mon days with ev ery fiber of her be ing, spent her days count ing the
hours un til the work day was over, and dragged her self home feel ing ex‐ 
hausted and dispir ited. Though it had hap pened sev eral times, she could
never ex plain this tra jec tory, not even to her self. Noth ing hap pened at work
to make her feel this way, but she felt dis tinctly that work was the sole rea‐ 
son for her dark en ing mood.
She vis ited me af ter try ing a num ber of ther a pies and de ter min ing that
none had helped. “Per haps the work place, not what hap pens there, brings
you down,” I sug gested. She didn’t see how this il lu mi nated her sit u a tion.
“Or,” I ven tured, “maybe it’s not the kind of work for you.” She was still
not im pressed with my in put. This was the work she’d done all her life and
where her ex per tise lay, she told me. “Plus,” she said, “I ac tu ally love HR.”
I sus pected that she needed to find a way to ap ply all that tal ent and ex‐ 
per tise in a dif fer ent kind of en vi ron ment. We ex plored her ex pe ri ences
with dif fer ent work en vi ron ments and quickly dis cov ered that she was
much bet ter at do ing spe cial as sign ments than at “keep ing the trains run ning
on time.” Rou tine meet ings, con fer ences, and round table sem i nars all felt
ex haust ing and gru el ing to her—and she be lieved them to be a gi ant waste
of time. Since her work had al ways been a daily amal ga ma tion of in di vid ual
projects and all forms of meet ings, she re al ized that she was be com ing worn
out from only cer tain as pects of the work.
Over time, she re al ized that if she stayed in the cor po rate world, she
would not be able to find a job that al lowed her to fo cus ex clu sively on the
kind of in de pen dent and self-di rected work that en er gized her. She was a
soloist who sim ply could not play in an or ches tra. So she de cided to open
her own HR con sult ing agency, which sup ported her need for in de pen‐ 
dence; she would be her own boss, which would al low her to spend her
work ing hours do ing only the things she liked to do. Eight years later, her
agency is thriv ing, her tal ents are much bet ter uti lized, and most im por‐ 
tantly, she ac tu ally looks for ward to ev ery Mon day.
D’s ex am ple il lus trates why otro verts are not suc cess ful within rigid in‐ 
sti tu tions where they are un able to be in con trol of how they spend their
time. And her ex pe ri ence is not at all un usual. Many otro verts I have coun‐ 
seled have de scribed be ing un able to func tion un der sim i lar cir cum stances;
they can not lie low, play nice, and toe the line, how ever they may try. The
fact is, the otro vert per son al ity is in com pat i ble with many fea tures of cor po‐ 
rate life: from be ing forced to waste hours a day in point less meet ings, to
hav ing projects stalled by red tape and bu reau cracy, to the ex haust ing task
of nav i gat ing all the power grab bing and sta tus seek ing (aka “of fice pol i‐ 
tics”). Worse yet is hav ing to watch their opin ions and ideas be brushed
aside in fa vor of the group con sen sus, all while work ing in an en vi ron ment
where they are be ing con stantly dis tracted by col leagues, clients, and an
ever-ex pand ing in box.
This is all ex ceed ingly tire some to otro verts, who sooner or later will
dis cover that they do their best work on their own, in en vi ron ments where
they can make their own de ci sions and are solely ac count able for the suc‐ 
cesses and the fail ures. With no one to ask, no one to con sult, and no one to
share the re spon si bil ity with—a ter ri fy ing prospect for com mu nal peo ple—
otro verts are free to do what they do best: think cre atively and ex pan sively,
out side the hive.
Choos ing the right job or ca reer is hugely im por tant for ev ery one, but
this is es pe cially true for otro verts. One rea son is that otro verts do not com‐ 
part men tal ize their lives, with one part ded i cated to work, one part ded i‐ 
cated to leisure, one to fam ily, and so on. Their in ner world—which is ob vi‐ 
ously present wher ever they are—is the epi cen ter of their lives. It is there‐ 
fore im pos si ble to thrive in a work en vi ron ment that is in com pat i ble with
their in ner lives.
When sit u ated within their com fort zone, otro verts can be ex tremely
pro duc tive and suc cess ful, even if that suc cess may not be ob vi ous. Al bert
Ein stein, per haps the most fa mous otro vert, was con sid ered men tally hand i‐ 
capped in child hood and was a high school dropout. He con ceived of rel a‐ 
tiv ity in his early twen ties while work ing as a clerk in the Swiss gov ern‐ 
ment patent of fice, which gave him time and space to think alone at his
desk while still pro vid ing enough struc ture to his days to pre vent him from
drift ing.
Be cause otro verts strive to adapt their work life to their abil i ties and in‐ 
abil i ties rather than try to change them selves to meet the de mands of a job,
ac cu rately iden ti fy ing their com fort zone is the key to pro fes sional suc cess
for otro verts. Other in gre di ents for pro fes sional suc cess in clude the fol low‐ 
ing:
A pro fes sion where non con ven tional think ing is es sen tial for suc cess.
A bal ance be tween ex po sure to oth ers and be ing alone. It can not be an
en tirely soli tary pro fes sion, but on the other hand, it can not be a pro‐ 
fes sion with con stant un mit i gated con tact with oth ers. The pres ence of
oth ers, even with out in ter ac tion (such as an open workspace or open-
door pol icy), is very dis tract ing to otro verts, who lack the abil ity to be
“al ways on.”
A pro fes sion where the otro vert has a clearly de fined role that sets
them apart from the rest of the group (sim i lar to the way a role helps
them in so cial sit u a tions).
Self-em ploy ment, or a pro fes sion that can even tu ally pro vide a path to
self-em ploy ment, such as work ing as a con sul tant or a free lancer or
own ing one’s own busi ness, as long as the day-to-day work doesn’t in‐ 
volve cold calls, so lic i ta tion, or de pen dency on many sup pli ers that
must be in ter acted with reg u larly.
A lead er ship role. Otro verts are nat u ral-born lead ers. In wardly de fi ant
in the face of au thor ity, they would rather tell oth ers what to do than be
sub ject to the rules,reg u la tions, and whims of oth ers.
A job that leaves time for cre ative pur suits and is also it self at least
par tially a cre ative pur suit.
A rhythm that cre ates a pre dictable rou tine—not much travel, and not
many meet ings or con ven tions out side the work place.
Whereas com mu nal peo ple can han dle soul-crush ing drudgery, the otro‐ 
vert can not ig nore a lack of job sat is fac tion. Otro verts can not barter with
them selves, as in “My work gives me no space for in di vid ual think ing but
com pen sates by of fer ing long week ends and many va ca tion days.” This is
re lated to otro verts’ un usual per cep tion of the pas sage of time. No minute
can be sac ri ficed. No phase of the day or of the year or of life is re dun dant.
Ev ery minute of life is im por tant and can not be “saved for the fu ture.”
In a way, suc ceed ing as an otro vert in a world of join ers is de pen dent on
re main ing an out sider in the work place. Un like many com mu nal peo ple,
otro verts don’t con sider their pro fes sion or job ti tle to be a cen tral part of
their iden tity; they de fine them selves by who they are rather than what they
do and feel no par tic u lar sense of con nec tion or loy alty to the or ga ni za tion
where they are em ployed.
Even the con cept of suc cess for otro verts is a per sonal rather than re la‐ 
tional con cept; psy cho log i cally, whether the team suc ceeds or fails is less
im por tant than the otro vert’s own per for mance. Suc cess is not pred i cated on
win ning, be ing rec og nized, mak ing a lot of money, or be ing pro moted, val‐ 
u a tions that are etched into the DNA of join ers. Whether the group con sid‐ 
ers an otro vert suc cess ful is ir rel e vant—otro verts achieve pro fes sional ful‐ 
fill ment by tap ping into their strengths, and do ing good work is much more
sat is fy ing when the oth ers have no power to grade their suc cess.
Most peo ple who want to be come prima bal leri nas are still con tent to
stay with the troupe as part of the en sem ble—some may ul ti mately dis cover
they pre fer to be in the sec ond tier. But not otro verts: they are soloists by
tem per a ment.
19
Old Age and Death
What does it ac tu ally mean to be long? I would ar gue that be long ing is a
fic tion, a con cept that ex ists only in our minds. In a way, noth ing be longs to
us, and we don’t be long to any thing. Even our most per sonal prop erty, our
body, is only ours to use for at most eight or nine decades, and our con trol
of its fate is lim ited at best. Just as pos ses sions can be taken away, de‐ 
stroyed, or lost, so can friend ships, ca ma raderie, and re la tion ships we con‐ 
sider “ours.” The il lu sion of own er ship over our so cial re la tion ships is up
there with the il lu sion of im mor tal ity and per ma nence.
We can, how ever, own our mem o ries. Otro verts know this in stinc tively,
and it al lows them to build rich, mean ing ful lives made up of unique mo‐ 
ments and ex pe ri ences, all the way to the end.
For most otro verts, the last decades of life are a time of peace and con‐ 
tent ment. Save for de bil i tat ing con di tions, they ar rive at the fi nal phase of
earthly life rather cheer fully. They have cu rated life around their needs, cul‐ 
ti vated a rich in ner world, and in vested in cre at ing pleas ant mem o ries,
which are the only as sets that truly be long to each of us. They un der stand,
at least on some level, that our ex pe ri ences are etched in our mem ory re‐ 
gard less of whether we want to re mem ber them or not. The pro tected stor‐ 
age of the mind makes ev ery in vest ment in mem o ries a se cure de posit: no
one can take it away from us.
Once most of life is in the rearview mir ror and mem o ries come to oc‐ 
cupy larger and larger swaths of the psy che, this in vest ment pays great div i‐ 
dends.
Com mu nal peo ple feel the ur gent slip page of life as they age. Hav ing
lived their lives un der com mu nal dic tates, many are sad dled with re grets
—“What was I think ing? How did I let my self…?” The re al ity that the exit
from this world, much like the en try, is a soli tary, lonely ex pe ri ence is ter ri‐ 
fy ing for com mu nal peo ple. With less fu ture to plan for and painful mem o‐ 
ries haunt ing them, their later years may be marred by dis tress. The barter
they so will ingly en gaged in for so long—the shared life in ex change for an
ex am ined one—starts los ing its buoy ancy as they ap proach old age.
Af ter a life time of choices dic tated by group norms, com mu nal peo ple
fi nally re al ize that the group can not teach each mem ber how to die alone.
Many find it quite dif fi cult to com mu ni cate with a dy ing loved one, and no
one can truly ever know what that per son is go ing through. It’s as though
the dy ing per son is sud denly to tally alone on a jour ney that no one can join
even if they want to. The ter ror of hav ing to face death alone, the re al iza tion
that to geth er ness was only an il lu sion, be comes in creas ingly in tol er a ble, as
com mu nal peo ple be come lonely and iso lated ex actly when they need oth‐ 
ers most. This is one of the para doxes of hu man ex is tence: at the end of life,
when fac ing what is ar guably the loneli est strug gle a per son can ex pe ri ence,
sud denly all the years spent de voted to the group evap o rate. Align ing with a
col lec tive can be a salve, or at least a dis trac tion, in the face of this ex is ten‐ 
tial dread. As David Fos ter Wal lace ob serves in his fa mous es say “A Sup‐ 
pos edly Fun Thing I’ll Never Do Again,”3 which de scribes a cruise va ca‐ 
tion he took through the char ac ter is ti cally otro vert lens of a de tached ob‐ 
server, “A va ca tion is a respite from un pleas ant ness, and since con scious‐ 
ness of death and de cay are un pleas ant, it may seem weird that Amer i cans’
ul ti mate fan tasy va ca tion in volves be ing plunked down in an enor mous pri‐ 
mor dial en gine of death and de cay. But on a 7NC Lux ury Cruise, we are
skill fully en abled in the con struc tion of var i ous fan tasies of tri umph over
just this death and de cay.… The 7NC’s con stant ac tiv i ties, par ties, fes tiv i‐ 
ties, gai ety and song; the adren a line, the ex cite ment, the stim u la tion. It
makes you feel vi brant, alive.… [This] op tion prom ises not a tran scen dence
of death-dread so much as just drown ing it out.”
For otro verts, their whole lives have, in a sense, been a soli tary jour ney,
so as the fi nal exit beck ons on the hori zon, they are less likely to fear dy ing
alone. The French philoso pher and au thor Al bert Ca mus wrote of how, in
the face of ex is ten tial dread, we can com mit philo soph i cal sui cide and join
a group that re as sures us of an af ter life, or ac cept our fate as en tirely our
own. Otro verts see their fate as theirs, and theirs alone. Be ing un bound by
any re li gion, the otro vert is not sub scribed to a pre or dained be lief sys tem
re gard ing what hap pens af ter death. In stead, the otro vert can cre ate their
own nar ra tive about their own fate. Whether this nar ra tive is “cor rect” is of
no con se quence; they are firm in their con vic tions be cause those con vic‐ 
tions are theirs and theirs alone.
When I started treat ing U, she was ninety-three and I was forty-three. At
this point in my life, I could not fathom how the end of life would feel, but
we of ten talked about death in our ses sions—not be cause she had fears she
needed to work through but be cause “at this stage,” she would say, chuck‐ 
ling, “death is the pri mary plan for the fu ture.” U was an es teemed aca‐ 
demic, a pro fes sor emerita at a pres ti gious uni ver sity who led a bo hemian
life in the East Vil lage—a heavy smoker in Levi’s. Even in her tenth decade
of life, she was spunky, opin ion ated, and self-re liant; based on these and
sev eral other qual i ties, I sus pected she had been a life long otro vert. She told
me that when she learned about the con cept of death as a child, she wasvery scared. Not about her own death but about the fu ture death of her par‐ 
ents and hav ing to con tinue with out them. Now that it was the other way
around—she would be leav ing peo ple be hind to con tinue with out her—she
was not afraid. She saw no rea son to be.
Many old peo ple are so mis er able at the end of life that they beg for
death, even as they fear it. But U was dif fer ent. “I still en joy most of what I
al ways have,” she told me. “Rose mary and laven der, good weed, cof fee,
look ing at the sun set, and walk ing. I’ve al ways lived my life for my self,”
she con tin ued. “Now I will die for my self with out re grets.”
It is no co in ci dence that in a com mu nal so ci ety such as ours, so many re‐ 
li gious tra di tions be lieve that our souls live on in some form, re leased from
the teth ers of our phys i cal body, af ter we die. Those who have lived their
lives among oth ers want to re turn to earth, where they can be with oth ers, or
end up in the af ter life with their de ceased fam ily mem bers. But even among
those who hold these be liefs, the un cer tainty—the not know ing for sure—is
what fright ens them the most. This was not the case for U. “Death makes
sense to me,” she ex plained. “It al ways made sense, and I have ar rived at
this junc ture as pre pared as I can be. I lived my per sonal life, of which I am
proud, be tween me and my self, and I will die my per sonal death.”
U died a few years later in her sleep, of old age. She was ninety-eight
and had lived her life to the fullest. She owed noth ing to any one and felt no
one owed her any thing ei ther. She had spent her life car ing for oth ers not
out of so cial obli ga tion or duty but out of em pa thy. Even at the very end,
she was not fear ful or bit ter or nos tal gic. I am not sure what she learned
from me, but I know what I learned from her: find ing peace in your life
makes it eas ier to feel at peace in death. And to find peace in your life, you
must first learn to be at peace with your self, which in cludes un der stand ing
and em brac ing the ways that you are dif fer ent from ev ery one else.
The fact that each one of us has one life, and that we each have a re spon‐ 
si bil ity to make the most of it, is uni ver sally un der stood but rarely acted on.
In some cases, that’s be cause we aren’t suf fi ciently in touch with our selves
to know what it means to make the most of our lim ited time. In other cases,
we might fear this at ti tude will be viewed as self-cen tered be cause it re‐ 
quires pri or i tiz ing your in di vid ual needs over the col lec tive’s rather than ig‐ 
nor ing the in ner voice that urges you to do some thing for your self. At al‐ 
most ev ery junc ture in our lives, the choice ap pears bi nary: you can ei ther
sac ri fice your needs for those of your group or act upon your urges with no
re gard for the rest.
If you are lucky enough to ar rive at old age, the fal lacy of that choice is
even tu ally laid bare. You re al ize that the bat tle be tween two op pos ing in ter‐ 
ests—yours ver sus the group’s—was never a fair fight. As death ap‐ 
proaches, the group doesn’t stop or slow down for you, which means you
have to learn to get along with your self, be cause as the ca ma raderie and the
to geth er ness slowly fade away, you are all that you have.
Otro verts have al ways known this. They have learned over their life‐ 
times that tak ing care of them selves is not mu tu ally ex clu sive with be ing
gen er ous and con sid er ate to oth ers: you can re main loyal to your self while
ne go ti at ing am i ca bly with the rest. You can de cide to like your self, or at
least ac cept your self. Af ter all, there is great peace in know ing that your
mind is the only thing you will ever truly own, that it can not be taken from
you, and that it will be with you un con di tion ally as you grow old and face
the end.
As Emily Dick in son wrote,
There is a soli tude of space
A soli tude of sea
A soli tude of death, but these
So ci ety shall be
Com pared with that pro founder site
That po lar pri vacy
A soul ad mit ted to it self—
Fi nite in fin ity.
Foot note
3 David Fos ter Wal lace, “A Sup pos edly Fun Thing I’ll Never Do Again,” A
Sup pos edly Fun Thing I’ll Never Do Again (New York: Lit tle, Brown,
1997).
Con clu sion
Otro verts are all around us. They have al ways been, even if we haven’t
had a name for them un til now. If, like me, you are one of them, I hope you
have rec og nized your self in these pages. Whether you are an otro vert or
not, I hope you will come away from this book with a greater ap pre ci a tion
for the virtues of the otro vert per son al ity, and what we all can learn from
them.
In re cent years, there has been much hand-wring ing over the record lev‐ 
els of lone li ness, alien ation, and po lar iza tion that plague our so ci ety to day.
Count less writ ers, thinkers, pol i cy mak ers, and even the US sur geon gen eral
have cited the de cline of com mu nal life as a prin ci pal cause of this men tal
health epi demic and pro posed a va ri ety of com mu nal so lu tions rang ing
from get ting off so cial me dia and ex pand ing our so cial sup port net works to
get ting more in volved in our lo cal com mu ni ties and so forth. In the ory,
these ideas are not with out merit. But in prac tice, we are a so ci ety hav ing
more and more con ver sa tions about the im por tance of com mu nity while
con tin u ing to be come lone lier and more di vided than ever. Otro verts are
well equipped not only to thrive in our frac tured, an gry world, but also to
show oth ers the way. The rea son for this is sim ple: they know how to forge
deep and ful fill ing re la tion ships with them selves.
Emo tional self-suf fi ciency is a pre con di tion for both hap pi ness and suc‐ 
cess, not just for them but for ev ery one. To be a valu able mem ber of a
group, a team, or a com mu nity, you must have a good re la tion ship with
your self too. De spite their pro cliv ity to fo cus on them selves rather than the
col lec tive, otro verts don’t es chew so cial con nec tion. They sim ply see peo‐ 
ple, in clud ing them selves, as in di vid u als, not just face less mem bers of a
group. It is easy to hate a form less group that you are taught to per ceive as
dif fer ent, in fe rior, or threat en ing. But it is much harder to gen er al ize your
hos til ity when you grasp peo ple as in di vid u als. Otro verts show us that it
does not need to be so hard to be gen uinely car ing about the plight of an‐ 
other. In dis man tling re duc tive no tions of “us ver sus them,” they demon‐ 
strate how to ex er cise em pa thy, bridge tribal dif fer ences, and get along with
peo ple bet ter.
So many of my pa tients come to see me be cause they are feel ing
weighed down by un nec es sary bur dens they put on their lives, for rea sons
they can’t un der stand. Their loads in vari ably be come lighter once they re al‐ 
ize that they do not need any one’s ap proval for any choice they make in
life. Otro verts un der stand this in stinc tively. But for com mu nal peo ple, it is a
cor rec tive emo tional ex pe ri ence. Be cause once we learn to dis tin guish be‐ 
tween our own needs and those of the group, then de cide for our selves
which ones re ally mat ter, our lives be come in fin itely eas ier. We be gin to
think of our selves as the lead char ac ter in our own lives rather than the ex‐ 
tra. We can lib er ate our selves from the hive mind and be gin to see the world
from a clearer, un ob structed per spec tive. Fa vor ing the group’s in ter ests over
our own is per haps good for get ting along with oth ers, but it is not suit able
for get ting along with our selves.
Otro verts are self-in ter ested, but they are not com pet i tive. Un for tu nately,
suc cess in a com mu nal en vi ron ment is based on com pe ti tion, which is of ten
un fair and tinged with ag gres sion. Be cause groups, es pe cially in the pro fes‐ 
sional world, are ruled by those who ad here to this way of be ing, our per‐for mance is be ing judged by those who are marked to suc ceed in this way.
Those who shy away from con fronta tion, who would pre fer not to be per‐ 
ceived as mean, and who are in clined to give rather than take are un likely to
suc ceed in com pe ti tion against those who are less thought ful and more
brazen. To even the play ing field, we teach them to con form to the pre dom i‐ 
nant be hav ior: to be as sertive, speak up, and stop be ing peo ple pleasers. In
so do ing, we re in force the toxic no tion that be ing kind and self-ef fac ing is a
weak ness.
Otro verts have much to teach these peo ple about how to suc ceed in a
gen tler, more benev o lent way. They refuse to blindly fol low the rules of ag‐ 
gres sion that they have nei ther ini ti ated nor fully un der stand. They de fine
suc cess by what one achieves, not by what one achieves in re la tion to oth‐ 
ers. And their con sid er a tion of oth ers stems from their nat u ral em pa thy
rather than be cause they have been taught to “be kind to oth ers.” Their les‐ 
son, and it is one I deeply be lieve, is that the best things in life are cru elty
free. There is al ways a choice to be ei ther help ful or hos tile, and so many
choose the lat ter, for no dis cern able rea son.
Otro verts don’t have this choice; they are com pelled to be con sid er ate.
No mat ter how many peo ple are present, otro verts see each one sep a rately.
In the ory, hu man ity ex tols benev o lence. How ever, in prac tice, com pet i tive‐ 
ness, con fronta tion, and dis crim i na tion are much more com mon than ac cep‐ 
tance or kind ness.
At best, our so ci ety re gards benev o lence as a form of so cial cap i tal and
not a goal in and of it self. This is sur pris ing, con sid er ing that the ex pe ri ence
of be ing kind is so re ward ing to you and ev ery one around you. We should
be very ea ger to be kind, but the re al ity is that while kind ness is com mend‐ 
able, hu mans re spect power more. And power is some thing hu mans are dis‐ 
in clined to share. In vir tu ally ev ery field, the most pow er ful po si tions are
reached by knock ing oth ers down along the way. This cre ates a vi cious cy‐ 
cle by which the more power one ac cu mu lates, the more self ishly and com‐ 
pet i tively one be haves. The truly al tru is tic among us may win our ad mi ra‐ 
tion but rarely achieve money, power, and the other trap pings of hu man suc‐ 
cess.
Be ing con sid er ate be cause of em pa thy rather than train ing is not only
more re ward ing, it also makes the lives of those around us more pleas ant. It
is a win-win sit u a tion. Just imag ine a world where ev ery one is gen tle and
con sid er ate. Where ev ery one is free to live a quiet life, free of con flict and
mal ice. A place where there is no so cial penalty for re fus ing to bully one’s
way to suc cess. This may sound like a utopia, but I be lieve it can be a re al‐ 
ity if the lessons of the otro vert life are shared widely.
As a child, I read and reread a beau ti ful story called King Matt the
First,4 about a child prince who be comes a king fol low ing his fa ther’s
death. He is try ing to cre ate just laws to ben e fit chil dren, but his best in ten‐ 
tions are thwarted by the adults act ing in their own self ish in ter ests. It was
writ ten by Janusz Ko r czak, a Pol ish pe di a tri cian who founded and ran a
Jew ish or phan age in War saw. When the Nazis con quered Poland and came
for the or phans, Dr. Ko r czak made the choice to die with them. Does it mat‐ 
ter that his death was no ble? I would ar gue not only that it does, but that the
foot print of his benev o lence con tin ues to ex ist. To me, Dr. Ko r czak is a gi‐ 
ant even if no one re mem bers him or King Matt the First.
A benev o lent foot print is not dif fi cult to at tain; all you need to do is tap
into your in ner rebel. In stead of un con di tion ally en dors ing the sta tus quo,
you can in ter ro gate and chal lenge it. You need not be an otro vert to re ject
the hive-mind con sen sus. It is a sim ple mat ter of cre at ing enough dis tance
be tween the self and the col lec tive.
Cru elty is far too high a price to pay for the priv i lege of be long ing.
Whether you are an otro vert or not, you need no per mis sion to let go of the
un kind, the cruel, and the self ish. At a time when the Trumpian hive mind’s
de mands for as sertive ness and ag gres sion grow louder and more in sis tent
than ever, it is up to all of us to choose the gen tler, kinder path. As Ib sen
wrote in An En emy of the Peo ple, “When so ci ety’s val ues are cor rupted, it
is the duty of the in di vid ual to up hold true moral ity.”
Foot note
4 Janusz Ko r czak, King Matt the First (War saw: Far rar, Straus and Giroux,
1923).
Are You an Otro vert?
Cir cle the num ber be low each state ment that ap plies to you. When
you’re done, add up your to tal points.
If you scored 188 or above, you are likely an otro vert. If so, I hope
this book has helped you bet ter un der stand and cel e brate this
unique facet of who you are.
If you scored be low 188, you are likely not an otro vert. If this is the
case, I hope this book has helped you bet ter un der stand and cel e‐ 
brate the otro verts in your life.
1 I feel lonely in large so cial gath er ings.
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2 I am truly close to very few peo ple in my life.
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3 I en joy par ties and party as of ten as pos si ble.
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4 I need a lot of time by my self.
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5 When I am sad I need peo ple to cheer me up.
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6 I like be ing alone; I am my best com pany.
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7 I am the first one to hear about hot new places.
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8 I like to work on my own.
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nor
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  7 6 5 4 3 2 1
9 I do not need oth ers’ ap proval for my be liefs.
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10 I am a fol lower of an or ga nized re li gion.
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11 I am a heavy user of so cial me dia.
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12 I have noth ing to hide, but I pre fer to keep my life to my self
any way.
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  7 6 5 4 3 2 1
13 I mis trust con ven tional wis dom; it is group think.
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  7 6 5 4 3 2 1
14 I con sider think ing an ac tiv ity.Very Strongly
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15 I am an ob server of life, not an ac tive par tic i pant.
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  7 6 5 4 3 2 1
16 I do not like to be alone.
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17 I think most peo ple do not know that I am shy.
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18 I like to wear bright col ors; they make me to stand out in the
crowd.
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19 I like to get at ten tion from those around me.
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20 The opin ion of oth ers is very im por tant to me.
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21 I think shar ing a work ing space is good for shar ing ideas.
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22 I like it when oth ers agree with me.
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23 I don’t mind be ing in the mi nor ity.
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24 I de velop a per sonal phi los o phy to guide my life rather than
adopt ing one from the out side.
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nor
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25 I want to be un der stood.
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26 I am some times scared by my own thoughts.
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27 I own and stand be hind my views.
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nor
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28 I think ev ery ques tion has an an swer.
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29 I don’t ac cept any ideas or no tions with out ex am in ing them
my self.
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nor
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  7 6 5 4 3 2 1
30 I have to be my own boss.
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31 I think that each prob lem has many pos si ble so lu tions.
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32 I think my teach ers or su pe ri ors are al ways right.
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nor
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33 I have my best ideas in meet ings.
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34 I am nat u rally eclec tic rather than spe cial ized.
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nor
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35 I rely on my self. Ask ing for help is dif fi cult.
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ther
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agree
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agree
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nor
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agree
agree
  7 6 5 4 3 2 1
36 When I share sto ries about my self, I try to be ac cu rate in ev ery
de tail.
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nor
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37 I be lieve the only wis dom is the one that is com ing down the
gen er a tions.
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nor
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38 I have a deep re spect for au thor ity fig ures.
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39 I love new ideas.
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ther
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nor
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40 I of ten ques tion my self.
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  7 6 5 4 3 2 1
Ac knowl edg ments
This is a work of an otro vert. As such it can not be the fruit of a team ef fort
and presents a dearth of peo ple to ac knowl edge. But those I men tion here
were in dis pens able to the mak ing of this book. There fore, these ac knowl‐ 
edg ments are short on col lab o ra tors but full of grat i tude.
First, I want to ac knowl edge Maya Beiser, my life part ner and the most
in flu en tial per son in my life. I also want to ac knowl edge our chil dren, Au‐ 
rielle and Do rian. Liv ing with my lit tle fam ily in peace and har mony has
been a great priv i lege and plea sure. They have al lowed me to find refuge
from the world churn ing out side and given me a rea son and a way to be‐ 
long.
My work on non-be long ing ex tended for many years, soli tary but not
iso lated. My thoughts have been in formed and re shaped by the most en dur‐ 
ing ex pe ri ence in my life: work ing with my pa tients. Many of the tenets in
the book, es pe cially those per ti nent to mak ing one’s life eas ier, were de vel‐ 
oped dur ing con ver sa tions with my pa tients, both otro vert and com mu nal. I
wit nessed the salient dif fer ence be tween a life of be long ing and a life of
out siders. I en deav ored to find so lu tions to what both ered each pa tient. I be‐ 
came adept at see ing the world of my pa tient with out judg ment or pre con‐ 
ceived no tions; in other words, with out my par tial i ties in ter fer ing with my
ca pac ity for em pa thy. In a way, I have lived many lives see ing the world
through my pa tients’ eyes. Over the years, my pa tients have gifted me a
mul ti fac eted, nu anced un der stand ing of hu man ity. With out them, this book
would not have been pos si ble. I am and have al ways been deeply grate ful to
my pa tients.
I want to thank those who lit er ally made this book pos si ble: Beth Davey,
my out stand ing and ded i cated lit er ary agent, and Talia Krohn, my fan tas tic
and bril liant pub lisher and ed i tor. They re ally “got it” and helped me pol ish
my thoughts and in fuse my voice into the text. I am very for tu nate to have
met Beth and Talia. With wis dom and kind ness, they helped me en ter the
un fa mil iar pub lish ing world and come out on the other side want ing to
writemore.
There are many sup port ive peo ple I met along the way who are not my
pa tients; thus, I al low my self to ac knowl edge them by name: Melanie Re‐ 
hak, Lind say Tay lor, Amy Phe lan, Mimi Stern licht, Amy Ju rkowitz, Faina
Shmu lyian, James Stone, Joan Shane brook, Yehuda Pearl, Joseph Sh pigel,
and Eli Meltz man.
Lastly, I want to ac knowl edge my first and most im por tant teacher in
psy chi a try, Dr. Kall man. I learned ev ery thing I know about be ing an otro‐ 
vert psy chi a trist by watch ing him with pa tients and lis ten ing to him share
his thoughts with me. How long would it have taken me to find my groove
had he not put my feet on the ground? Dr. Kall man, if there is an otro vert’s
heaven, know ing you, you must have given your well-de served place to one
of your pa tients or stu dents. I am eter nally grate ful to you.
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About the Au thor
RAMI KAMIN SKI, MD, is a pi o neer ing psy chi a trist with more than four
decades of ex pe ri ence treat ing pa tients across the spec trum, from world
lead ers to in di vid u als with per sis tent psy chi atric con di tions. His ex per tise
in cludes mood dis or ders, ob ses sive-com pul sive dis or ders, anx i ety, ad dic‐ 
tion dis or ders, and neu rocog ni tive con di tions. With a par tic u lar fo cus on in‐ 
te gra tive psy chi atric ap proaches, Dr. Kamin ski’s method uniquely bridges
hu man is tic val ues with in no va tive ther a peu tic con cepts.
Based in New York City, Dr. Kamin ski con tin ues to ad vance health care
through op ti mized treat ment pro to cols, with re cent pi o neer ing work in ad‐ 
dic tion treat ment. His con tri bu tions to men tal health in clude the de vel op‐ 
ment of the F.A.M.E. (Fore cast, As sess, Man age, Em power) pro to col, de‐ 
signed to ad dress the psy cho log i cal chal lenges of sud den fame, in 2018. In
2023, he founded the Oth er ness In sti tute, where he in tro duced the Oth er‐ 
ness Scale—a method for iden ti fy ing and mea sur ing traits of oth er ness and
otro ver sion.
Dur ing his ten ure at Mount Sinai Med i cal Cen ter, Dr. Kamin ski made a
dis cov ery about his tamine’s role in de gen er a tive brain dis or ders, lead ing to
eleven in ter na tional patents.
In the pub lic sec tor, Dr. Kamin ski served as med i cal di rec tor for op er a‐ 
tions and com mis sioner li ai son to fam i lies at the New York State Of fice of
Men tal Health, where he im ple mented sev eral in no va tive pro grams. No‐ 
table among these is the Sec ond Chance Pro gram, which has gained in ter‐ 
na tional recog ni tion for its ex cep tional out comes.
Dr. Kamin ski’s out stand ing con tri bu tions to psy chi a try have earned nu‐ 
mer ous ac co lades, in clud ing the Ex em plary Psy chi a trist Award from the
Na tional Al liance for the Men tally Ill and Mount Sinai Hos pi tal’s Physi cian
of the Year award. As di rec tor of psy chi atric med i cal stu dents’ ed u ca tion at
Mount Sinai School of Medicine, he was awarded the Ex cel lence in Ser vice
Award and in ducted into the Med i cal Honor So ci ety Al pha Omega Al pha,
ce ment ing his legacy as both a prac ti tioner and an ed u ca tor in the field of
psy chi a try.
	Ti­tle Page
	Copy­right
	Ded­i­ca­tion
	In­tro­duc­tion
	PART I. THE FOUN­DA­TIONS OF NON-BE­LONG­ING
	1. What Is an Otro­vert?
	2. How the World Mis­un­der­stands Otro­verts
	3. The Meek Rebel
	4. The Pseudo Ex­tro­vert
	5. The Cre­ative
	6. The Em­path
	PART II. A WORLD MADE FOR JOIN­ERS
	7. We Are All Born Otro­verts
	8. A Cul­ture That Re­wards Join­ing
	9. The Fal­lacy of Fit­ting In
	PART III. THE VIRTUES OF BE­ING AN OTRO­VERT
	10. Emo­tional Self-Suf­fi­ciency
	11. Em­pa­thy and Con­nec­tion
	12. Con­fi­dence and Con­tent­ment
	13. Think­ing Out­side the Hive
	14. The Rich­ness of In­ner Life
	PART IV. THE OTRO­VERT LIFE
	15. The Otro­vert Child
	16. Run­ning the Gaunt­let of Ado­les­cence
	17. Ro­man­tic Re­la­tion­ships
	18. Otro­verts at Work
	19. Old Age and Death
	Con­clu­sion
	Ap­pen­dix: Are You an Otro­vert?
	Ac­knowl­edg­ments
	Dis­cover More
	About the Au­thoran alien. Do you think there’s some thing wrong with
me?”
I cer tainly didn’t think any thing was wrong with him, but I won dered if
he did and asked him. “Yes,” he said, echo ing his mother’s words. “I think I
am not nor mal. Why don’t I like what ever my friends like? It can’t be that
they are all wrong and only I am right.”
It wasn’t hard to see why he felt this way. Cross ing all cul tures and tra‐ 
di tions, one force rules teenage groups: pres sure to fit in. So how do we un‐ 
der stand some one like A, who does not care about fit ting in? The an swer is
sim ple: A was an otro vert.
A was very re lieved by my ex pla na tion. I in vited him to come and speak
with me again af ter he had given some thought to this way of think ing
about him self, and when he did, he said that our con ver sa tion had pro vided
a flash of clar ity, mak ing him re al ize that a sense of not be long ing was the
com mon thread of most of his so cial dif fi cul ties.
He asked me to ex plain this to his par ents, which I did, urg ing them not
to pres sure him to be “like all the other kids.” At first, this was not easy on
them. Peo ple around them were al ways in sist ing that they should force their
son to at tend par ties and go to sum mer camp and par tic i pate in all the things
that four teen-year-old boys typ i cally do. “He will thank you for that later,”
ev ery one in sisted. “Chil dren don’t know what they need. You have to teach
them.” These peo ple were wrong.
To day, to the de light of his par ents, A has truly blos somed. Now twenty-
four, he’s get ting a PhD in psy chol ogy, re cently got en gaged to his col lege
girl friend, and re mains close with his best child hood friends. In some ways,
he’ll al ways re main an ob server of the group and never a true par tic i pant.
But he is a full par tic i pant in his own life: deeply sat is fied with the things
he chooses to do and the peo ple he chooses to be with. This is the ideal path
for an otro vert.
THE OTRO VERT VIEW OF THE WORLD
In ev ery group, there are be liefs and rules (spo ken and un spo ken) that mem‐ 
bers of the group must share in or der to be in cluded. Com mu nal peo ple—a
cat e gory that in cludes in tro verts, ex tro verts, and out siders who have been
marginal ized—want to be in vited into the group, and they val i date the be‐ 
liefs and rules of that group by do ing ex actly what it pre scribes. The hive
mind is an other name for this highly preva lent form of col lec tive think ing
Otro verts, on the other hand, think out side the hive. They don’t par take
in the shared vi sion that group mem bers have, and the group’s cen ter of
grav ity does not ex ert any pull on them the way it does on ev ery one else.
Here is a vis ual rep re sen ta tion of the dis tin guish ing fac tor be tween com‐ 
mu nal peo ple and otro verts, and the per spec tive through which each views
the world. Com mu nal peo ple look to the cen ter of the cir cle, where ev ery‐ 
one else’s opin ions con verge. For otro verts it is the op po site. Even when
they stand in side the group, they face out ward.
Com mu nal peo ple are al ways ori ented around the group’s cen ter, but
each for a dif fer ent set of rea sons.
In tro verts find it ex tremely dif fi cult to forge deep one-on-one re la tion‐ 
ships with oth ers and shy away from op por tu ni ties for emo tional in ti macy,
so they seek com mu nal re la tion ships in stead, un der stand ing that in a cir cle
con tain ing many peo ple, it is eas ier to keep their dis tance from any one who
wants to get too close. For this rea son, be long ing to a group—some times
quite pas sion ately—is im por tant to them, even if they tend to be quiet and
shy in the way they in ter act with it. Be cause so cial in ter ac tions quickly
drain their en ergy, they may spend time with the group only in small doses;
the shared iden tity and knowl edge of their be long ing pro vide a sense of se‐ 
cu rity and com fort.
Ex tro verts love an au di ence and par tic i pat ing in a shared iden tity in
ways that al low them to shine so cially, so they need the group in or der to
act out those ten den cies. They de rive en ergy from be ing around other peo‐ 
ple and crave a de gree of ac tiv ity and so cia bil ity that one-on-one re la tion‐ 
ships of ten can not sat isfy. They thrive on the re wards of so cial in clu sion
and the high sta tus that comes with be ing charis matic enough to reap them.
Out siders are shunned by the group, of ten even os tra cized by their peers,
start ing with the loos en ing of adult su per vi sion in the mid dle school years.
But be cause they’re al ways yearn ing to be in cluded, they are that much
more ori ented to ward so cial cir cles that re ject them.
Each of these ori en ta tions is fo cused on cre at ing a shared iden tity that
su per sedes the in di vid ual one. Whether they are an in tro vert, an ex tro vert,
or an out sider, the com mu nal per son is will ing to sac ri fice their unique but
lonely jour ney for a com mon ex pe ri ence that of fers them the im pres sion
that they are not alone.
Otro verts, by con trast, are al ways fac ing out side, even when they are
stand ing on the in side. They are wel comed into the cir cle, but they never
feel part of the shared ex pe ri ence tak ing place in side it. While out siders
and, to some de gree, in tro verts are so cial lon ers, otro verts are emo tional
lon ers—they feel the most alone when sur rounded by oth ers. Many might
be de scribed as “pop u lar lon ers,” a con tra dic tion the otro vert some times
finds al most un bear able. Fac ing out ward makes the otro vert’s per spec tive
in creas ingly sep a rate from that of the col lec tive, in clud ing other otro verts;
it’s as though there is an in vis i ble yet im pen e tra ble bound ary be tween them
and all the oth ers. The otro vert’s jour ney is soli tary, as ev ery hu man jour ney
es sen tially is. The dif fer ence is that otro verts can not ig nore that truth, as
most peo ple ei ther try or are able to do.
Each of these ways of be ing has its ben e fits and draw backs, but re gard‐ 
less, none of us can choose which one we are. Much like left-hand ed ness,
be ing an otro vert is a cog ni tive fea ture, deeply em bed ded in our brain’s
wiring. In the same way that we now con sider ef forts to force left-handed
chil dren to “switch hands” (as was the com mon prac tice of par ents and
teach ers un til the early 1900s) mis guided, so are at tempts to “fix” otro verts
by in sist ing that they try to fit in or be long.
Left-handed peo ple can live com fort ably in a right-handed world as long
as they are left alone to be who they are; forc ing them to use their right
hand merely cre ates un nec es sary dis com fort and dif fi culty. Sim i larly, giv ing
otro verts the space to be who they are will al low them to feel in creas ingly
com fort able, es pe cially in adult hood, when the pres sure to be long lessens.
Once otro verts are free from the pres sures of well-mean ing in di vid u als urg‐ 
ing them to join ac tiv i ties in which they have no in ter est, soli tude be comes
an op por tu nity for free dom, for em brac ing a sense of self in de pen dent of
oth ers, for al low ing self-ac cep tance to blos som. No mat ter what this time
alone is spent on, all that mat ters is that it be at tuned to the needs and de‐ 
sires of each otro vert. This lib er a tion from de pen dency on oth ers’ opin ions
opens up the pos si bil ity of a be spoke, self-de ter mined life tra jec tory that
brings con tent ment.
THE CORE QUAL I TIES OF OTRO VERTS
There are many nu ances to the otro vert per son al ity, which I’ll get into more
in the up com ing chap ters, but the fol low ing are the fun da men tal qual i ties
that all otro verts share—and how they man i fest in daily life.
Lack of a com mu nal im pulse.
Otro verts are not nat u ral join ers.
They al ways pre fer to get to gether with a friend one-on-one rather than
in a group. When they have to at tend com mu nal gath er ings,they are
the per son stand ing off to the side, deep in con ver sa tion with an other
per son; they never “work the room.”
They are not likely to throw them selves birth day par ties and gen er ally
avoid group cel e bra tions of any kind.
They would rather do school projects or work as sign ments in di vid u ally
than in a group (even if that means tak ing on more work).
They de spise or ga nized ac tiv i ties and would much rather va ca tion
solo, even in a re mote, un fa mil iar des ti na tion, than go on a group trip.
They pre fer sports and ac tiv i ties where they can com pete in di vid u ally
(ten nis, golf, run ning, hik ing, etc.) rather than sports where they have
to play on a team (soc cer, base ball, etc.).
They have trou ble be ing re laxed and them selves in pub lic, no mat ter
how com mon the sit u a tion. They can en gage in small talk with out
awk ward ness but are eas ily bored by it and find even ba nal in ter ac‐ 
tions (like talk ing to a gro cery store clerk or ex chang ing pleas antries
with a neigh bor) se cretly ir ri tat ing.
They are un com fort able in groups and in crowded places such as el e‐ 
va tors or lines where small talk tends to break out to pass the time.
Otro verts are soloists who can not play in an or ches tra. They are fiercely
in de pen dent, happy to sit on the side lines, and nei ther need nor tol er ate
code pen dency. The writer Rud yard Kipling en cap su lated this way of think‐ 
ing when he wrote, “The in di vid ual has al ways had to strug gle to keep from
be ing over whelmed by the tribe. If you try it, you will be lonely of ten and
some times fright ened. But no price is too high to pay for the priv i lege of
own ing your self.”
Al ways an ob server, never a true par tic i pant.
Otro verts se cretly feel like out siders in any group, re gard less of
its mem bers.
They never truly feel a con nec tion to the group it self or its shared iden‐ 
tity, even if they con nect in di vid u ally with ev ery one in it.
They don’t like mix ing peo ple from dif fer ent realms of life, even if
those peo ple know each other. For ex am ple, they would be un com fort‐ 
able bring ing a spouse to the of fice hol i day party, where they would be
re spon si ble for in te grat ing their spouse into the group ex pe ri ence.
They don’t feel an affin ity with a par tic u lar sports team, an alma mater,
or a com pany they work for. These things aren’t part of their iden tity in
the way they are for most peo ple.
Otro verts are for ever non par tic i pants; they are mere ob servers, watch ing the
so cial dance. A com mu nal per son will go on a cruise and form new bonds
with strangers who be come friends by the time the ship has docked again.
But an otro vert will re turn feel ing more alone than ever.
The great writer and ex is ten tial ist Jean-Paul Sartre was well ac quainted
with this feel ing, which he ar tic u lated per fectly in his first novel, Nau sea:
“I am alone in the midst of these happy, rea son able voices.”
Non con form ing.
Otro verts don’t just march to the beat of their own drum; they
march to the beat of an other in stru ment al to gether.
They pre fer to stand out than to fit in.
They like what they like and are not in ter ested in pop u lar cul ture. They
have no in ter est in see ing that movie that ev ery one is rav ing about or
dy ing to see, or dress ing the way ev ery one else dresses (un less those
things are aligned with their ex ist ing per sonal style or in ter ests).
They can be con fi dent and charm ing in large gath er ings when they
have an as signed role or task—such as host, key note speaker, or DJ—
that vis i bly sets them apart from the crowd.
David Fos ter Wal lace, an other one of my fa vorite otro vert writ ers, per‐ 
fectly ex pressed the otro vert’s dis dain for ac tiv i ties oth ers seem to en joy in
his first novel, The Broom of the Sys tem, when he ob served, “Mod ern party-
dance is sim ply writhing to sug ges tive mu sic. It is ridicu lous, silly to watch
and ex cru ci at ingly em bar rass ing to per form. It is ridicu lous, and yet ab so‐ 
lutely ev ery one does it, so that it is the per son who does not want to do the
ridicu lous thing who feels out of place and un com fort able and self-con‐ 
scious… in a word, ridicu lous. Right out of Kafka: the per son who does not
want to do the ridicu lous thing is the per son who is ridicu lous.”
In de pen dent, orig i nal think ing.
Otro verts re ject the hive mind. They don’t think in the way the
group col lec tively thinks and don’t care about what the group
col lec tively cares about. They are in touch with who they are.
They stand by their opin ions and con vic tions. If asked to weigh in on
some thing at work, they aren’t swayed by the opin ions their col leagues
have ex pressed.
They do not ask for ad vice about how to live but read ily ac cept ad vice
from ex perts in sub jects that they have no ex per tise in (lawyers,
plumbers, etc.).
They are spe cial ists rather than gen er al ists, with in ter ests and skills
that run nar row but deep. For ex am ple, when asked a ques tion that
falls out side my area of ex per tise, I of ten joke that it falls un der the 80
per cent of things I am bad at. But I like to think that I am not just
good, but ex cel lent, at the re main ing 20 per cent of things.
Vir ginia Woolf’s A Room of One’s Own is, of course, a sem i nal fem i nist
text. But I see it also as a book that could only have been writ ten by an otro‐ 
vert who ex pe ri enced daily life en tirely lib er ated from the shared ide olo gies
or opin ions that a so ci ety tries to im pose on all of its mem bers. As she
wrote in de fi ance, “Lock up your li braries if you like; but there is no gate,
no lock, no bolt that you can set upon the free dom of my mind.”
The sim ple re al ity is that there is no such thing as be ing “a bit otro‐ 
verted.” It’s bi nary; you ei ther are or are not an otro vert, which means ei ther
you buy into the hive mind or you don’t. Be longers have many per mu ta‐ 
tions, from the fa nat i cal ad her ent to the dis af fected, from those who are cast
out to those who are crowned. Some try to be like oth ers; some sink into
solip sism. Non-be long ing, in con trast, is to tal and im mutable. But rather
than view it as a bur den to carry, otro verts can learn to see the many ben e‐ 
fits and bless ings that ac com pany this facet of who they are. It is never too
late to live your life as you and no body else.
2
How the World Mis un der stands Otro‐ 
verts
Unlike many other hu man vari a tions, otro ver sion is a cog ni tive style that
doesn’t nec es sar ily re sult in a cor re spond ing set of ac tions. It’s also a feel‐ 
ing: an emo tional re sponse to be ing in her ently alien ated from the group.
Otro verts are out siders who are treated like in sid ers. Con trary to be ing
shunned like other out siders, they are al ways wel comed into the fold. They
sim ply don’t feel like they be long to the group and never did. But be cause
they wear their dis com fort qui etly, they are of ten mis taken for other kinds
of peo ple who share this qual ity, for en tirely dif fer ent rea sons. Here are the
most com mon of those.
IN TRO VERTS
In tro verts are shy and reclu sive, mainly pre oc cu pied with their in ner world.
Otro verts are acutely aware of other peo ple and can not find refuge in side
them selves when sur rounded by oth ers. If any thing, they are too at tuned to
the world around them.
My pa tient M had pos sessed this qual ity for as long as he could re mem‐ 
ber, though it had be come more dis tract ing with the pass ing years. He’d be‐ 
come bur dened by the in tense at ten tion to mood and sit u a tion that he felt
com pelled to pay to ev ery one he came across, ir re spec tive of how ran dom
and tem po rary they were in his life. This height ened aware ness was born
out of his in abil ity to ac cess the hive mind, which made ev ery group an
enigma, even when each in di vid ual within was trans par ent to him. He foundev ery per son (and not just the un usual peo ple) in ter est ing, even fas ci nat ing,
and was con stantly, if in vol un tar ily, col lect ing data about the peo ple around
him. In the pres ence of a group, this ca coph ony of thoughts and ob ser va‐ 
tions, which must be con sid ered to lack an “off switch,” was ex haust ing for
him, but he didn’t find one-on-one in ter ac tions drain ing the way an in tro‐ 
vert might.
He once de scribed to me the way he ex pe ri ences pro fes sional con fer‐ 
ences: “When we have a cock tail hour fol lowed by a sit-down din ner, I am
su per un com fort able dur ing the stand ing part and much bet ter dur ing the
sit ting part.” He won dered why in the same place, with the same peo ple, he
could have such a dif fer ent ex pe ri ence. I ex plained that the dif fer ence was
in the num ber of pos si ble in ter ac tions with dif fer ent peo ple. Sit ting with
peo ple at a ta ble lim its your pos si ble in ter ac tions to the three or four peo ple
around you, whereas at a cock tail hour you are ba si cally ex posed to ev ery‐ 
one there; peo ple come and go, ex change pleas antries, and move on.
Most peo ple don’t at tach strongly to peo ple they chat with briefly at a
cock tail hour, so their tran si tions from one to the next are smooth and im‐ 
per cep ti ble. But M’s deep in ter est in each per son made those kinds of fleet‐ 
ing in ter ac tions al most painful. Like many otro verts, he couldn’t han dle the
end less cy cle of fast, ca sual at tach ment and de tach ment. Sit ting at a ta ble
with oth ers, while still un com fort able, was im mea sur ably eas ier, but once
din ner was over and peo ple started milling around and min gling, his dis‐ 
com fort re turned. “That’s why you should leave right af ter the sit-down din‐ 
ner,” I ex plained. “Otro verts are mas ters of the ‘Irish exit.’”
While some otro verts avoid this feel ing by spend ing a lot of time alone,
their emo tional dis com fort can present very dif fer ently in pub lic com pared
with the be hav ior of in tro verts. Whereas in tro verts pre fer to fade into the
back ground, otro verts love the spot light. M, for ex am ple, is not re served or
shy; he is out go ing, speaks a lot, and is en ter tain ing. He is in his el e ment
when the group is small or when he has a so cial role to play that dis tin‐ 
guishes him from the rest, and can be very con fi dent and vo cal in a small-
group gath er ing. (I call this be ing a “pseudo ex tro vert” and will have more
to say about it in chap ter 4.) Be cause otro verts do not com pare them selves
to oth ers, know what they are good at, and need no re as sur ance, they can
come across as cocky rather than dif fi dent or def er en tial, as in tro verts of ten
are. They en joy soli tary time, but their soli tude is not about de tach ment
from the rest, like it is for in tro verts, but about a strong at tach ment to the
self.
NON CON FORMISTS
The most pas sion ate in di vid u al ist can still be long to a group. Even if it is a
“herd of in di vid u als” in which mem bers be lieve they’re each unique, they
are none the less part of a group bonded by com mon iden tity; non con‐ 
formists tend to band to gether, just like con form ists. For otro verts, how ever,
in di vid u al ism is not a philo soph i cal stance, or even a choice. Otro verts are
in di vid u al ists by de fault. Their non con formism is not an act of re bel lion, a
means of self-ex pres sion, or a bid for at ten tion. It is an es sen tial trait that
in forms how they see their world.
So ci ety com pels hu mans to per ceive their re al ity as closely as pos si ble
to the way those around them do. (In deed, psy chosis is de fined as hav ing
pri vate rather than com mu nal per cep tions.) As a re sult, com mu nal peo ple
are so eas ily in flu enced by oth ers that most can be con vinced that some‐ 
thing ex ists even if they don’t per ceive it them selves. Not only that, but
they feel reaf firmed by the be lief that “ev ery one knows” some thing, even if
they don’t poll “ev ery one” reg u larly. Once con vinced that some thing is “the
norm” (an other com mu nal tool), most peo ple ac cept it with out much in‐ 
quiry or sec ond thought and of ten never re visit the con cept. Non con formists
are not im mune to this; af ter all, they must be lieve that the norm ex ists in
or der to rebel against or sub vert it. Otro verts, on the other hand, don’t rec‐ 
og nize the ex is tence of the norm in the first place.
The ar rival of the in ter net has brought bet ter and more ef fec tive strate‐ 
gies to en sure con formism, one un in tended con se quence of the in for ma tion
su per high way. Be yond al low ing ideas and trends to travel faster and spread
more widely, the very de sign of the so cial web en sures that the com mu nal
im pulse con trols the dis sem i na tion of in for ma tion; al go rithms fa vor eye‐ 
balls, which means that the more peo ple who have viewed or en gaged with
a news ar ti cle, a so cial me dia post, or a prod uct rec om men da tion, the more
likely oth ers are to view and en gage with it. Hence “in flu encers” (the epit‐ 
ome of com mu nal tools), whose suc cess is based on a cir cu lar ar gu ment:
peo ple ac cept what the in flu encer sug gests be cause they are an in flu encer,
and they are an in flu encer be cause many peo ple have ac cepted what they
sug gest. On the in ter net, one need not be an ex pert—or even pre tend to be
one—to get oth ers to agree with one’s opin ions and fol low one’s ad vice.
The only fac tor is pop u lar ity (in the form of likes and fol low ers), and pop u‐ 
lar ity grows by con sen sus. For the same rea sons, any kind of dis sent fails to
at tract at ten tion in the vir tual land scape that the con sen sus ef fi ciently and
con vinc ingly con trols.
Otro verts aren’t sus cep ti ble to this, or any kind of so cial in flu ence. Their
per cep tions and pref er ences are in flu enced by their per sonal in ter ests and
point of view rather than by group con sen sus. Otro verts can not be co erced
to re lin quish their ver sion. A rose can be a rose when ev ery one sees a rose.
But the idea of a rose—its in ter pre ta tion—can be very dif fer ent for the otro‐ 
vert, who can not be co erced to re lin quish their ver sion, even if it dif fers
from that of the ma jor ity.
Take, for ex am ple, a flag. For com mu nal peo ple, a flag is im bued with
spe cial value as a sym bol of unity for those iden ti fy ing with it. But for the
otro vert it is merely a piece of cloth. An otro vert I’ll call T re calls how, dur‐ 
ing her se nior year in high school, as all her class mates were ac cepted to
and en rolled in var i ous col leges, stick ers bear ing the schools’ names be gan
to ap pear, one by one, on the bumpers of their cars. To her class mates, these
bumper stick ers were both an an nounce ment of their fu ture plans and a dec‐ 
la ra tion of be long ing to the col lege com mu nity they had agreed to join, but
for T, who had also re ceived such a sticker along with her ac cep tance let ter,
it was just a piece of pa per with ad he sive on one side. She wasn’t try ing to
be dif fer ent from the rest when she threw hers in the trash; she sim ply
didn’t see any point in putting it on her car. Otro verts see the same pic ture
as all the rest. How ever, they don’t give it a com mu nal mean ing or in ter pre‐ 
ta tion.
Be ing un bound by con ven tion and un teth ered from the com mu nal wis‐ 
dom gives otro verts an ex hil a rat ing sense of free dom and au ton omy. In stead
of re ly ing on the col lec tive to mold their ex pla na tions of the world, they can
shape and re shape their own ex pla na tions at will—a type of free dom many
com mu nal peo ple find scary.
SO CIAL ANX I ETY
Pa tient DC came to see me af ter hav ing suf fered from anx i ety for many
years. She had been di ag nosed and treated for so cial anx i ety in the past but
had found no re lief.
She de scribed her con di tion as “out side anx ious ver sus in door calm.” In
acrowd, she felt over whelmed, crip pled by anx i ety, and des per ate to es cape
back home. Even when she was sur rounded by good friends, the stress of
be ing out in the world did not dis si pate. “Strangely, they be come a part of
all the rest,” she ex plained, “and I feel very lonely and lost. The harder they
try to un der stand and help me, the worse I feel.”
Good friends typ i cally lessen so cial anx i ety in pub lic; their fa mil iar ity
mit i gates the fear of the un known. But this was not hap pen ing for DC.
Next, I asked her to be spe cific about sit u a tions in pub lic or away from
home where she didn’t feel anx ious. She came up with be ing in her car and
sit ting at an out door café or restau rant. Then she added that in a movie the‐ 
ater, she only felt com fort able sit ting in the last row—and that the same was
true on buses and trains. “I don’t like peo ple look ing at me from the back,
so if I sit in the back, I feel less anx ious even if the bus is very crowded.”
Next we moved on to her work life, which took place in a huge of fice
build ing in Mid town Man hat tan. When I sug gested it must be very hard to
work among so many peo ple, she replied that al though vis it ing other of fice
build ings caused her dis com fort, at her own of fice, she was all right. There
were clearly a num ber of pub lic sit u a tions in which she was not ex pe ri enc‐ 
ing anx i ety, so I asked her to look at those as a sep a rate group and see if
there was a com mon thread among them. She’d never con sid ered it from
that an gle. “It has felt like one big blob of anx i ety!” she told me. “But now
that I think of it, I don’t get why sit ting out doors, even on a busy street, is
eas ier than sit ting in doors in the same café. It’s equally crowded and loud.”
She paused for a sec ond. “Maybe I also have claus tro pho bia?” Then she
smiled. “I guess I’m even weirder than I thought!”
I coun tered with a dif fer ent pos si bil ity: the dif fer ence be tween those two
states was her re la tion ship to the peo ple she shared space with. In sit u a tions
that made her un easy, like stand ing in line be hind half a dozen oth ers at a
gro cery store, she was be ing forced to “par tic i pate” in the crowd. But in the
other sit u a tions, like sit ting alone in her car or at an out door café, she was
an ob server of a group rather than an ac tive par tic i pant in it. Even in a the‐ 
ater or on a crowded bus, sit ting in the back seat gave her an ob server’s
view. She needed to be able to read the room to find her place in it and feel
com fort able.
In an a lyz ing her trig ger ing sit u a tions through the otro vert prism, it be‐ 
came clear why her pre vi ous treat ment did not work: be cause it was de‐ 
signed for so cially anx ious be longers, whose dis com fort is rooted in a sense
of self-con scious ness about their de vi a tion from what oth ers con sider “nor‐ 
mal” rather than a sense of non-be long ing. Be cause otro verts aren’t so cially
pho bic, tac tics to re lieve them of so cial pho bia don’t help. Through our
work to gether, DC came to un der stand that she did not feel self-con scious
about ap pear ing un like oth ers and that the so lu tion to her anx i ety was not
learn ing to be more com fort able blend ing into the crowd. Non-be long ing is
nor mal for otro verts and need not be cor rected. In stead of learn ing to be‐ 
long, the otro vert’s goal should be to un der stand their true strengths and
lim i ta tions and, in do ing so, de velop a keen ap pre ci a tion of them selves. Do‐ 
ing this work led DC to make choices that were bet ter suited to her needs,
which im me di ately lib er ated her from her dif fi cul ties.
MARGINAL IZA TION
So cially marginal ized peo ple are those who want to be part of a group but
are side lined, ejected, or never ad mit ted into the fold to be gin with. Otro‐ 
verts are not cast out of the group against their will; they never be longed
there in the first place.
Out wardly, otro verts can seem like part of the group, es pe cially dur ing
the early decades of life. They can be pop u lar, well liked, and even viewed
as lead ers. Based on their so cial po si tion, they can ap pear to the ob server to
be suc cess ful in sid ers, but they al ways feel like out siders. The otro vert’s
sense of non-be long ing, in other words, does not re flect their ac tual so cial
stand ing. Un like un pop u lar in sid ers, they are not bul lied, os tra cized, or un‐ 
in vited. But the dis so nance be tween look ing and act ing like an in sider while
feel ing like an out sider is tir ing, lead ing them to with draw from the group
in fa vor of one-on-one re la tion ships and avoid ing un nec es sary so cial obli‐ 
ga tions. They cre ate a com fort zone where they are un en cum bered by group
dy nam ics, pro tect ing their en ergy with self-im posed so cial bound aries.
NEU RO DI VER GENCE
Be hav ioral pre dictabil ity is es sen tial for so cial com fort among strangers. In
fol low ing a pre dictable set of so cially pre scribed rules, we are con stantly (if
sub con sciously) seek ing to re as sure oth ers that we can be trusted, and they
re cip ro cate in kind.
Neu ro di ver gent peo ple are di ver gent only rel a tive to neu rotyp i cal peo‐ 
ple, who en counter them in ways that the col lec tive psy che finds un pre‐ 
dictable. That is es pe cially true for peo ple on the autism spec trum, who
have a num ber of cog ni tive traits that make it dif fi cult to con form to the so‐ 
cial scripts with which neu rotyp i cal peo ple are com fort able. Those traits in‐ 
clude the fol low ing:
Dif fi cul ties in un der stand ing so cial cues and en gag ing in typ i cal so cial
in ter ac tions
Chal lenges in ver bal and non ver bal com mu ni ca tion
En gag ing in repet i tive be hav iors and hav ing highly fo cused in ter ests
Sen sory sen si tiv i ties, such as ad verse re ac tions to spe cific sounds or
tex tures
Otro verts do not dis play any of these cog ni tive par tic u lar i ties. Nor do
they dis play the char ac ter is tics as so ci ated with ADHD, which is es sen tially
an in abil ity to man age the in ter play be tween be ing at ten tive to the task at
hand and sup press ing other stim uli that may grab one’s at ten tion. Peo ple
with ADHD strug gle to fix ate on one spe cific as pect of their aware ness, in
some cases, to the point where they can’t con cen trate on what a con ver sant
is say ing, are for get ful, and are con stantly dis tracted and fid gety. Those
neu rocog ni tive symp toms are of ten in ter preted as “bad be hav ior,” which is
why chil dren and teenagers with ADHD are of ten shunned by the group.
But peo ple with ADHD are fun da men tally com mu nal peo ple who, in the
best-case sce nario, are aware of their inat ten tion and the dis rup tion it causes
and make ef forts to ad here to the rules one must ad here to in or der to be‐ 
long.
Otro verts are neu rotyp i cal. Their brains func tion no dif fer ently than
those of com mu nal peo ple, and they dis play no dis cernible be hav ioral dif‐ 
fer ences from neu rotyp i cal peo ple. As I’ve said, the ex pe ri ence of non-be‐ 
long ing is com pletely in ter nal. Un like peo ple with ADHD, otro verts don’t
strug gle with fo cus or at ten tion—if any thing, they are above av er age in
their at ten tive ness. Be cause otro verts are very con sid er ate and non con‐ 
fronta tional and make a great ef fort to be pre dictable to oth ers—of ten at
great ex pense to them selves—they do not elicit the kinds of neg a tive re ac‐ 
tions that neu ro di ver gent peo ple of ten do.
Will fully not be long ing in a world made for join ers can be chal leng ing.
How ever, it is not an im ped i ment to any pur suit the otro vert wishes for and
can even be the otro vert’s great est gift.
3
The Meek Rebel
When we think of rev o lu tion ar ies—peo ple who think out side the bounds
of reg u lar so cial struc tures—we pic ture strong and force ful peo ple who
over turned the pre vail ing or der and changedthe course of his tory. Many ex‐ 
am ples im me di ately spring to mind: Robe spierre, Marx, Lenin, and Si mon
Bolí var, to name a few, along with some hor ri ble dic ta tors such as Hitler,
Mao, and Stalin. What all these peo ple have in com mon is that their re bel‐ 
lion in vari ably in volved ral ly ing other peo ple: sup port ers, col lab o ra tors,
and by standers on one hand, and op po nents on the other. Whether this took
the form of a small, un der ground up ris ing or a swell of pub lic sen ti ment, it
was al ways a shared ex pe ri ence.
Otro verts think out side the bounds, too, but all their rev o lu tion ary ideas
are pri vate, con tained within them selves. Otro verts are there fore what I call
meek rebels. Meek re bel lion is not shared, vi o lent, or even no tice able, for
the most part. But it does have a pur pose for the in di vid ual; it is the non-be‐ 
longer’s re sponse to liv ing in a com mu nal world.
Meet ing a meek rebel is in vari ably a pleas ant ex pe ri ence. They are nat u‐ 
rally very po lite and tend to be peo ple pleasers: con fronta tion averse and of‐ 
ten con sid er ate to a fault. Any so cial dis com fort that their un ortho dox,
coun ter in tu itive, or coun ter cul tural ideas might cause is mit i gated by a re‐ 
luc tance to ex press them. Ea ger to ac com mo date, care ful not to dis turb, and
mor ti fied by in tru sion on oth ers, they may be mis taken for weak or self-ef‐ 
fac ing. But this dis arm ing at ti tude is far from a weak ness; it is a sur vival
tac tic. Even when find ing the con sen sus in tol er a ble or wrong headed, otro‐ 
verts be have cau tiously, well aware that ques tion ing or protest ing would
dis rupt so cial har mony. They would never, for ex am ple, at tend a po lit i cal
rally, par tic i pate in a walk out to protest a com pany pol icy, or min gle with
fans of a par tic u lar sports team while wear ing the shirt of its ri val (at least
not of their own vo li tion). Though they of ten dis agree with how the cap tain
is steer ing, they do not care to rock the boat.
This is in part be cause be ing them selves in the pres ence of the group is
per ilous to otro verts, as it may call at ten tion to their vari a tion from those
sur round ing them. With out the nat u ral im pulse to con form to the com mon
de nom i na tor, they must care fully ob serve, learn, and prac tice ad her ing to
the un spo ken rules of en gage ment as a means of cam ou flag ing their in ter nal
re bel lion and non con formism. The meek rebel du ti fully stands in line, waits
for green lights, says the ap pro pri ate thing, and so on—not in stinc tively, but
through an in ex orable process of ob serv ing how oth ers be have for cues. But
while they are of ten stick lers for the rules, they never re spect them in tel lec‐ 
tu ally.
Though otro verts are not de lib er ately sub ver sive, this com plete free dom
from con formism may elicit sub ver sive ideas that in some cases can in flu‐ 
ence the mul ti tudes, or even the course of his tory. Galileo, who helped
change the way we un der stand the cos mos, is a prime ex am ple of this. Hav‐ 
ing re al ized, as a re sult of his ex per i ments and ob ser va tions, that the earth
re volves around the sun, he faced the wrath of the Catholic Church, which
al lowed no chal lenge to the con ven tional think ing that the earth was the
cen ter around which ev ery thing else re volved. He quickly re canted his dis‐ 
cov ery un der the threat of death, but he never stopped re belling in ter nally,
as he knew he was right. Even tu ally, of course, he was proved cor rect.
This in ner re bel lious ness also ex tends to hive tra di tions such as cer e‐ 
monies and hol i days. Shared tra di tions or rit u als—be they re li gious, na‐ 
tional, or orig i nat ing in the sur round ing com mu nity—rarely feel com pelling
to otro verts, who strug gle to an chor them selves in the so cial back ground of
these tra di tions. Even the mile stones typ i cally deemed wor thy of cel e bra‐ 
tion—birth days, an niver saries, grad u a tions—feel ar bi trary to otro verts.
Otro verts do, how ever, an chor them selves in per sonal habits and tra di‐ 
tions. This pref er ence for per sonal rit u als over shared ones gen er ally frees
otro verts from un nec es sary (and un pleas ant) obli ga tions like re li gious ser‐ 
vices, col lege re unions, and New Year’s Eve cel e bra tions, but at the same
time, it can also make them in flex i ble and rigid about their habits and rou‐ 
tines.
The in sis tence on their own rou tines and tra di tions of ten ren ders otro‐ 
verts un ad ven tur ous, lack ing in care free spon tane ity, and ap pre hen sive or
in se cure when forced out of their ha bit ual com fort zone. The same dar ing
spirit that takes them to the un charted re gions of thought is ab sent from the
ex pe ri en tial side of life. This is en tirely by choice. Free dom for otro verts is
an in ter nal ex pe ri ence rather than a phys i cal one. They value their peace of
mind over “ex cite ment” and self-con trol over ex per i men ta tion and risk-tak‐ 
ing. Any thing that might cause an adren a line rush—metaphor i cally or lit er‐ 
ally—is un ap peal ing to them, as it car ries the risk of los ing con trol. Even in
the most mun dane, ev ery day sit u a tions, los ing con trol is a threat to their au‐ 
ton omy.
One pa tient of mine de scribed ob fus cat ing triv ial and mean ing less facts
of his daily life—things like what he ate for lunch and where—as one of his
fa vorite acts of in ter nal re bel lion. “The triv ial, harm less na ture of my fib‐ 
bing serves as a lit tle dig into the very peo ple I feel alien ated from,” he ex‐ 
plained, re fer ring to these small lies as “otro vert ag gres sive acts.” This kind
of covert dis obe di ence to the group gives otro verts an ex hil a rat ing sense of
free dom. It is a way of de fend ing their in ner world—which is their life’s
most im por tant di men sion—with out cre at ing un wanted con flict or at tract‐ 
ing un wanted at ten tion.
This ten dency to ward out ward meek ness is not a prob lem in and of it‐ 
self. How ever, it could be come prob lem atic for an otro vert grow ing up in a
fam ily that views gen tle ness as a weak ness or even a char ac ter flaw. In
those fam i lies or en vi ron ments, otro verts—and par tic u larly boys—are of ten
forced into ac tiv i ties that are con sid ered emo tion ally strength en ing, or
“char ac ter build ing.” Sadly, while of ten made with good in ten tions, at‐ 
tempts to force otro verts “out of the com fort zone” fre quently put them in
ex actly the kinds of sit u a tions that cause them emo tional an guish. The more
their par ents and teach ers and peers at tempt to “fix” them so that they can
be more like all the other kids, the more un com fort able, emo tion ally ex‐ 
hausted, and de feated many otro verts be come. Their meek ness even tu ally
over takes their in ter nal re bel lion, and a form of learned help less ness sets in
as their very way of be ing in the world, im pos si ble for oth ers to un der stand,
is taken from them. This can lead some to col lapse into the men tal health
sys tem or sim ply re treat into a soli tary life de void of the re ward ing con nec‐ 
tions they could have had.
In my first year of res i dency train ing, I was as signed to the case of an
eigh teen-year-old man who had spent most of his teenage years in the hos‐ 
pi tal’s psy chi atric day pro gram, where he was di ag nosed with schizophre‐ 
nia. I’d been told that E was awk ward and shy and found it dif fi cult to
main tain eye con tact, but one-on-one with me, he was very ex pres sive and
sen si tive and dis played no delu sions, hal lu ci na tions, or other symp toms of
psy chosis, a fact that I ini tially at trib uted to the large dose of med i ca tion he
was on. He also wrote po etry and was well-read and neatly groomed. None
of this was con sis tent with the pre sen ta tion of schizophre nia, which is self-
ne glect ful, flat, and un emo tive.And yet, the di ag no sis of schizophre nia
seemed ev i dent to all the ex pe ri enced staff mem bers. As a rookie psy chi a‐ 
trist at the time, I con sid ered my fail ure to elicit “schizophre nia symp toms”
a mat ter of lack of ex pe ri ence or in ep ti tude. I as sumed he must be suf fer ing
from an other “type” of schizophre nia that I had yet to come across.
We met daily, as was the prac tice in the clinic, and soon formed a
friendly rap port. We dis cussed sci ence fic tion and other shared in ter ests,
and E was con sis tently en gaged, spon ta neous, and bright. Speak ing to his
par ents for more back ground, I found them dot ing, fright ened, and heart bro‐ 
ken about their only son’s dire di ag no sis. All of that was un der stand able.
Then I asked why they had first be come con cerned about him. They an‐ 
swered that while E had al ways been a friendly and gen tle child who did
rel a tively well in school, in re cent years he had been “iso lat ing” in ways
they found con cern ing. He had a few friends, but he only liked to spend
time with them in di vid u ally for rea sons un clear to his par ents, and, like
most teenage boys, he was awk ward with girls. Though his class mates con‐ 
sid ered him a lit tle “weird,” he didn’t seem to care and was happy to be in
his room, build ing model air planes and tin ker ing with ra dios and other elec‐ 
tronic de vices. He did not seem re motely fazed by his alone ness. E’s school
coun selor had men tioned the pos si bil ity of autism, but he didn’t ex hibit the
symp toms of that ei ther. When asked to ex plain his prob lem, all he could
tell the coun selor was that he felt “dis con nected” from oth ers. With no other
the o ries on the ta ble, when doc tors de liv ered the di ag no sis of schizophre‐ 
nia, his par ents never ques tioned it.
As the weeks went by, I be came even more skep ti cal of the schizophre‐ 
nia di ag no sis. At last, I de cided to try ta per ing the an tipsy chotic med i ca‐ 
tions while watch ing E closely for the emer gence of psy chosis. It never ap‐ 
peared. In fact, with out the med i ca tions’ side ef fects, E be came more an i‐ 
mated in pub lic, and his mood bright ened con sid er ably. I was cer tain his di‐ 
ag no sis was in cor rect, but I didn’t know what to call his state of be ing—as
far as I could tell, he was a friendly and gen tle young man who sim ply
needed con sid er able time off from his peers.
Af ter two years, I con cluded my train ing and left the hos pi tal. E and I
con tin ued to com mu ni cate for years af ter that. He was dis charged and
started vol un teer ing at a cen ter for in tel lec tu ally dis abled in di vid u als, a call‐ 
ing that he con nected with so strongly that he pro ceeded to study coun sel‐ 
ing and even tu ally be came a di rec tor of the agency. He did not take med i ca‐ 
tions, nor was he ever read mit ted, though he also strug gled to build a rich
per sonal life. I now be lieve that had I fully un der stood the true na ture of his
dif fi cul ties dur ing our time to gether or even soon af ter, I could have of fered
a more pro duc tive and op ti mistic vi sion of his fu ture, along with the as sur‐ 
ance that be ing an otro vert was in no way an im ped i ment to ful fill ing it.
4
The Pseudo Ex tro vert
We are all fa mil iar with ex tro verts: they are the peo ple who are al ways
the life of the party, who seem to know ev ery one and ex cel at talk ing to
peo ple in any sit u a tion.
Many (though not all) otro verts are what I call “pseudo ex tro verts.”
They may feel un com fort able with a group of peo ple, but not in the way
that shy or in tro verted peo ple do. They don’t find them selves tongue-tied or
re frain from at tract ing at ten tion. In large pub lic spa ces such as on a pub lic
beach, in a packed sta dium, or even on a crowded street—any where many
strangers con gre gate—they are prone to dis com fort and may feel awk ward
and in hib ited. But when they are in more con tained and fa mil iar cir cum‐ 
stances, they can be quite charm ing and so cia ble.
They don’t read ily en gage in small talk and find it hard to hide their dis‐ 
in ter est in pop u lar cul ture. But given the chance to tell a funny story or a
joke or lis ten em path i cally, otro verts are friendly and out go ing and can en‐ 
gage in mean ing ful con ver sa tion. But the bound ary be tween self and oth ers
re mains. Otro verts are soli tary at heart, and the gre gar i ous per sona they
adopt for pub lic dis play is of ten a pro tec tive shield with which they fiercely
guard their in ner life.
Play ing the gre gar i ous so cial izer while be ing deeply pri vate is quite tax‐ 
ing on otro verts, es pe cially in the ear lier stages of life. For tu nately, the
pseudo-ex tro vert ten dency usu ally does not linger be yond young adult hood.
As otro verts get older, it be comes eas ier to avoid sit u a tions that make them
un com fort able. This change is em i nently pos si ble, as adult hood tends to of‐ 
fer op por tu ni ties for more struc tured so cial iz ing—an in ti mate din ner party
or meet ing one-on-one for a cof fee, for ex am ple—rather than sim ply hang‐ 
ing around in big groups as we tend to do in our younger years. In con trast
with the open-ended form of so cial iz ing that de fines our high school and
col lege years, most “adult” events have a pur pose and of ten a start and end
time. And in the work place, un like in school, there are am ple op por tu ni ties
to form one-on-one friend ships, en gage in more struc tured so cial iz ing
(invit ing a col league to lunch, for ex am ple), and choose a ca reer cen tered
on in di vid ual work rather than group projects.
One otro vert re called for me how, in her first year of col lege, she
couldn’t bear how all the stu dents in her dor mi tory left their doors open all
the time and were con stantly wan der ing in and out of each other’s rooms,
form ing and re-form ing groups in the com mon room or out on the lawn.
She was in ter ested in form ing friend ships with some of her in di vid ual fel‐ 
low stu dents but had no in ter est in the con stant shared ex pe ri ence, in spite
of al ways be ing in vited in and even urged to join. She was able to at tend
cam pus events and even par ties so long as she knew about these events in
ad vance, but the con cept of “hang ing out”—spon ta neously and with out any
real struc ture or pur pose—was for eign, con fus ing, and, as she put it,
“frankly, quite bor ing” to her.
This is not un com mon for otro verts. De spite hav ing no real de sire to
par tic i pate in what all the oth ers are do ing, in their ado les cent and early
adult years, when they are most sus cep ti ble to so cial pres sures and to the
grav i ta tional pull of the group, otro verts want to want to do these things.
The so cial pres sure to blend in can be pow er ful, es pe cially dur ing those
teenage and young adult years. But there is an ex cep tion to this: when otro‐ 
verts are handed a so cial role—such as team leader, host, coach, or pre sen‐ 
ter, for ex am ple—they of ten shine, even in large groups. It may seem like a
nar cis sis tic need to be re garded as some one spe cial, but a des ig nated po si‐ 
tion makes group at ten dance tol er a ble by giv ing otro verts a so cially ac cept‐ 
able way to main tain their bound aries and set them selves apart. It does not
have to be an el e vated role, only a very dif fer ent one from the rest. For ex‐ 
am ple, one teenager I know feels com pelled to at tend his friends’ par ties, as
he doesn’t want to be rude, but he al ways plays the role of DJ so he doesn’t
blend in with the crowd.
This brings me back to my pa tient DC, whom you met in chap ter 2—the
“out side anx ious ver sus in door calm” otro vert who was most com fort able in
the world as an ob server. My dis cov ery of this trait led me to ask her if she
had trou ble with pub lic speak ing, a role that fo cuses the spot light on an in‐ 
di vid ual—the ex act op po site of be ing an ob server—which