The Psychopathology of
Power:
Mood, Hubris, and Leadership
Nassir Ghaemi MD
Tufts University
Harvard Medical School
Honest history
Positive aspects of mood illness
– Depression: Realism, Empath
– Mania: Creativity, Resilience
– Limitations of mental health (Reverse stigma):
Conformism
Nassir Ghaemi, A First-Rate Madness, New York,
Penguin Press, 2011
JF Galvez, SB Thommi, SN Ghaemi, J Affective
Disorders, 2011, 128-185-190
New Psychohistory
Scientific not speculative
– Not psychoanalytic – Freud/Erikson
– Documentation: 50 year rule
Symptoms
Genetics (Family History)
Course
Treatment
– Severity of symptoms
– Effects
Depressive Realism
Contingency tests
– 25% green light after button press
½ both groups recognized control
– 75% green light after button press
6% of normal students recognized control vs 50% of
depressive group
– Add money $5 per green light –
normal students misinterpreted control as before
– Lose $5 per green light
Normal students more realistic
LB Alloy, LY Abramson, Journal Exp Psychology, 1979, 108:441-485
Heads I win, Tails it’s chance
90 Yale students, 30 coin tosses
– called out beforehand, asked how accurate at guessing
and whether could improve with practice
Descending outcomes group
– told repeatedly early that they were correct
Ascending outcomes group
– told early that they were incorrect and then more correct
Truth group: told the truth
Descending group was less realistic (Leston Havens)
EJ Langer and J Roth, J Personality Social Psychology, 1975, 32: 951-955
SE Taylor, DA Armor, J Personality 1996, 64:873-898;
RA Cummins, H Nistico, J Happiness Studies, 2002, 3:37-69
Positive illusion
Breast cancer
– “a mildly disturbing disregard for the truth”
– Correlated with better clinician-judged
psychological adjustment
Skew of happiness
– 0-100 scale (16 studies of life satisfaction)
– Average score 75, range 70-80
– 90% above score of 50 – most everyone feels
happier than average
(hence no such thing as average)
Empathy
Biology
– Oxytocin
– Mirror neurons
Insula – 10% of brain
Psychology
– Cognitive, affective, sensory, motor (nonverbal)
Depression – depressed group vs normal controls,
correlation with severity
– Affective, not just cognitive
JF Galvez, SB Thommi, SN Ghaemi, J Affective Disorders, 2011, 128-185-190
Mental Health
Roy Grinker: Homoclites
– N=343, George Williams College, N=75 selected, 2
year examination
– 85% lacked even the mildest mental abnormality
– “Upright young men”
– Mediocrity?
Health: Norm + normal versus ideal
RR Grinker et al, Arch Gen Psych, 1962, 6:405-453
Muscular Christianity
–
–
–
–
George Brush is my name,
America’s my nation
Ludington’s my dwelling place
And Heaven’s my destination
Being normal: Homoclites
Mental Health
George Vaillant
– Well-adjusted personality (work and love)
– ML King
David Owen
– Hubris Syndrome
GE Vaillant, Adaptation to Life, Little Brown 1977
D Owen, In sickness and in power, Praeger, 2008
D Owen, The hubris syndrome, Methuen, 2012
Great ill leaders
Mania
– William Sherman
Not George McClellan
– Ted Turner
Depression
– Winston Churchill
Not Neville Chamberlain
– Abraham Lincoln
– Mahatma Gandhi
– Martin Luther King Jr
Healthy poor leaders
Chamberlain
McClellan
Nuremberg Nazi trials
Modern leaders?
– Richard Nixon?
– George W. Bush
– Tony Blair
George McClellan
Neville Chamberlain
Nuremberg Nazi leaders
How to enhance realism?
Oppose the culture of self-esteem
– “You are not special”
Teach self-doubt
– The scientific attitude
– Richard Feynman: Cargo cult science
Teach non-conformism
– Emerson’s self-reliance
How to enhance empathy?
Spirituality – Eastern traditions, existential
equality
Teaching nonviolent resistance
– Not simple pacifism
Oppose conformism
– social doubt, related to self-doubt
– Karl Jaspers