The Enneagram and Chronic Illness: How Fives, Sixes, and Sevens React to Being Sick

There are many emotional, physical, and spiritual struggles associated with chronic pain and illness. Lately, I’ve been wondering if my personality exacerbates certain issues, making me more susceptible to particular frustrations. Do I have a certain attitude towards my pain that is different from others? Are there things I can learn from my personality type that will help me manage my chronic illness better? 

This led me to a fascinating research project by Penny Whillans, a psychologist and the Director of the Canadian Institute for Enneagram Studies. Whillans conducted a study on how personality types react to chronic pain present in a clinical setting, and linked her findings to the Enneagram. I also researched and interviewed people who have typed themselves so we can understand, on a more personal level, the variety of experiences that come with pain and illness.

This week, I’m looking at Type Fives, Sixes, and Sevens. The Enneagram bases personality types around three centers of intelligence—the gut (or instinctive) center, the heart (or feeling) center, and the head (or thinking) center. Though everyone uses all three methods to process their environment, everyone has a dominant center of intelligence, a default response. Fives, Sixes, and Sevens are the head centers, which means the base their actions on what their mind tells them to do.

Enneagram 5: If I Can Understand My Pain, I Won’t Be Helpless.

Type Fives (Investigators) want to understand their environment and may seem aloof because they are uncomfortable sharing personal details. They detach from their emotions because feeling things is draining. Fear is the core emotion of Fives, Sixes, and Sevens. While Sixes react to fear by being suspicious and constantly searching for sources of danger and Sevens seek out pleasurable experiences to avoid fear, Fives wall themselves off from situations where they might feel fear or anxiety. They withdraw to protect their energy, time, and space. Fives are knowledgeable, perceptive people who feel emotions deeply even if they don’t show that to others.

Fives want to know why they are experiencing pain, and they want to know the reasoning behind the treatments doctors prescribe. Fives can get frustrated with the experimental nature of treatments—since doctors often don’t know what’s wrong, sometimes they just suggest trying medications, exercises, tests, programs, etc. to see if they help.

Whillans writes, “The Type #5s wanted to hear logically presented information about pain and long term pain. They wanted to learn about ‘coping’ and to learn how to increase their ability to concentrate without the pain interfering.”

Fives ask a lot of questions, wanting to understand their bodies and know that their health care practitioners are competent.

“I do a lot of research and reading about my condition or what could be causing my pain,” says Christine, a Five with chronic pain. “I’m the type of person who searches for a diagnosis, but am hesitant/fearful to take action when I think I’ve figured it out and can procrastinate doing things that may actually help because of anxieties… I am the type to not bring things up with a Dr. until I have a good idea of the direction I want to take and the help that is available to me.”

Fives may struggle with being unable to completely understand their conditions. They may get frustrated when their doctor doesn’t have the “answer,” and will benefit from a doctor who is willing to go over the research and the reasoning behind treatment options. They may need to practice sitting with the discomfort of not knowing and coming to peace with being in this limbo area where diagnoses and solutions aren’t readily available. Taking the time and space to deal with the difficult emotions, including anxiety, that accompany chronic illness is also valuable. As much as you’d like to, you can’t wall yourself off from this kind of pain; confronting it with your loved ones at your side (and your doctors at your back) may prepare you for those emotions.

Enneagram 6: I Worry About My Pain Because No One Else Will.

Type Sixes (Loyalists) want to feel safe and secure. They are good at predicting problems, planning, and preparing, because they want to feel ready in case something bad happens. Fear is the core emotion of Fives, Sixes, and Sevens. While Fives wall themselves off from stressful situations and Sevens seek out pleasurable experiences to avoid fear, Sixes are suspicious and constantly searching for sources of danger. Sixes are hard-working, reliable people who are slow to trust, but when they do are very loyal.

The Type #6s were referred by practitioners who saw them as “dramatic” and anxious about their pain,” Whillans writes. “Without exception, they wanted help to return to work and to their pre-pain lives. These goals changed during treatment to wanting to trust themselves, their pain and their bodies.”

Getting out of their own heads and relaxing more can be tricky for Sixes.

In “Letting Go Of The Lie That Is Mom Guilt While Living With A Chronic Illness,” Katie Saville, who has ankylosing spondylitis, writes, “As if being in chronic pain isn’t bad enough, I find myself consumed with worry over what my children must think of me and how they must compare me to other moms… ‘What must they think of me? How must they feel? What is going through their heads?’ … If one thing was for sure, it was that I had to put an end to this toxic way of thinking.”

Chronically ill sixes may get stuck in anxiety about being sick, whether they’re worrying about getting sicker, about treatments not working, about trusting their doctor’s advice, about friends or family thinking poorly of them, or about the pain itself. This anxiety can actually make pain levels worse, so it helps to find healthy ways to cope with it. Dealing with anxiety is no easy feat because anxiety is not logical. Therapists will have advice on ways to manage it. Getting out of your own head and doing something may help the Sixes’ tendency to overthink things—whether it’s trying a treatment a doctor has suggested or distracting yourself with a hobby. Accepting that your pain may not be “solvable” for the time being and learning to be in touch with your body may help as well.

Enneagram 7: Thinking Positively Will Help Me Ignore My Pain.

Type Sevens (Enthusiasts) are fun-loving and unconsciously afraid of being trapped in unpleasant experiences. Fear is the core emotion of Fives, Sixes, and Sevens. While Fives wall themselves off from stressful situations and Sixes are constantly on the lookout for danger, Sevens seek out pleasurable experiences to avoid fear. Sevens are optimistic visionaries who want things to be better for everyone.

Whillans writes about Sevens with chronic pain,  “The Type #7s projected their discomfort and demonstrated a low tolerance for uncomfortable topics, inclusive of talking about their pain… Understatement of pain and pain experience was the chief way of coping in order to maintain a familiar sense of self.”

Sevens have a wonderful habit of reframing things in a positive light. This can be useful for living with chronic pain because they can find peace and hope through this reframing. But it can also cause problems when the reframing goes so far that the Seven finds themselves in an imaginary place and refuses to confront reality.

I avoid and run from pain like the plague, both emotional and physical, and when I do have pain I do everything I can to distract, avoid, hide from, and numb pain,” says John, a Seven with chronic knee pain. “Sevens and pain do NOT get along.”

Sevens don’t want to be in pain, don’t want to talk about being in pain, don’t want to admit they are in pain. This denial can wall the Sevens off from treatment, understanding, and coping mechanisms. There is value in going to the dark places they are afraid of, letting themselves feel those difficult emotions, acknowledging the pain and attempting to learn what’s behind it. You may not be able to “solve” your pain or make it go away, but you can learn to manage it. Sevens may also find value in stopping, evaluating their needs, and learning how to rest.

Check out the previous posts in this series, which feature the other six personality types and how they react to chronic pain. Disclaimer: I am not a doctor or a medical professional. These posts are not intended as medical advice.


Chestnut, Beatrice, The Complete Enneagram: 27 Paths to Greater Self-Knowledge. Berkeley, CA: She Writes Press, 2013.

Daniels, David, M.D. “Working with the Enneagram Harmony Triads.” Dr. David Daniels,

“Eneagram Centers of Intelligence.” Enneagram Explained, Jan 21, 2020,

Riso, Don Richard and Russ Hudson. The Enneagram Institute, 1997,

The New School at Commonweal. Beatrice Chestnut – Type 5 Enneagram Panel, YouTube, Apr 29, 2019,

The New School at Commonweal. Beatrice Chestnut – Type 6 Enneagram Panel, YouTube, Apr 30, 2019,

The New School at Commonweal. Beatrice Chestnut – Type 7 Enneagram Panel, YouTube, May 1, 2019,

Whillans, Penny. “Applying the Enneagram to the World of Chronic Pain,” The Enneagram Journal, July 2009,

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