The Psychopathology of Power: Mood, Hubris, and Leadership

1. The Psychopathology of Power:Mood, Hubris, and Leadership Nassir Ghaemi MD Tufts University Harvard Medical School

2. 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

3. New Psychohistory • Scientific not speculative • Not psychoanalytic – Freud/Erikson • Documentation: 50 year rule • Symptoms • Genetics (Family History) • Course • Treatment • Severity of symptoms • Effects

4. 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

5. 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

6. 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)

7. 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

8. 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

9. Muscular Christianity • George Brush is my name, • America’s my nation • Ludington’s my dwelling place • And Heaven’s my destination

10. Being normal: Homoclites

11. 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

12. 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

15. Healthy poor leaders • Chamberlain • McClellan • Nuremberg Nazi trials • Modern leaders? • Richard Nixon? • George W. Bush • Tony Blair

16. George McClellan

17. Neville Chamberlain

20. Nuremberg Nazi leaders

21. 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

22. 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