Leadership is about people, which means it is about psychology, which studies personality, character, motivation, emotions, attitudes, socialisation, morality, how we learn, and how we think. And since psychology is a science in crisis, it seems reasonable to suggest a link with the global leadership deficit.
This is not an attack on psychology or psychiatry, important disciplines with significant benefits. Nor is it a repudiation of pharmaceuticals, also the source of great good. Nor do we deny the reality of mental illness, which causes so much suffering. However, given claims of a mental health crisis, what are the implications for leadership?
Answering that question requires us to consider the accuracy of the claim that society is ‘sick’, the nature of the crisis in the mental health profession, the broader context of postmodern western culture, and the proper response of a leader in the circumstances.
The US spends $113 billion annually on mental health, around 5.6 percent of the health-care budget, and some 100,000 psychologists, 200,000 social workers, 100,000 mental health counsellors, 50,000 marriage and family therapists, 15,000 nurse psychotherapists, and swarms of life coaches, non-clinical social workers, and substance abuse counsellors, are active. The percentage of people on psychiatric drugs, and the statistic of one in four Americans suffering a diagnosable malady in any year, certainly suggest a sick society, while rates of narcissism, relationship breakdown, suicide, and violence, are hard to ignore.
Science has improved diagnoses, but has also spawned the growth of vested interests. Research demands funding, which generates commercial activity; drug companies need sales, practitioners need patients, bureaucracy needs dependents, and politicians need votes. Mental health is big business.
Closely related are the problems of the profession. Apart from the sometimes sordid history of psychology, there are epistemic challenges. The different schools of psychology and their disagreements indicate that there is much about the science that remains uncertain. There is no consensus on what mental conditions are real, what symptoms indicate, what can be cured or controlled, or what mental health actually means.
Contentious theories about personality, and the therapies flowing from them make matters worse. Moreover, practitioners are often ill-equipped to empathize with the worldviews that shape the thinking and behavior of their patients. They too frequently, and quite unscientifically, identify such beliefs as neuroses.
Jerome Kagan, professor of psychology at Harvard worries that researchers, beguiled by technology, ignore the culture, socio-economic status, and life experiences of patients. Meaning and purpose are as basic to psychology as genes to biology, and concepts like depression, fear, and stress, can only be understood in the contexts where they occur. Firm ethical beliefs and the confidence inspired by a just society are vital for mental well-being.
Kagan decries the diagnostic inflation of the Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition. Allen Frances, chair of the DSM-4 task force, also rejects the idea that we are all somehow mentally disordered:
“People who have mild and transient symptoms don’t need a diagnosis or treatment…Medication is essential for severe psychiatric problems but does more harm than good for the worries and disappointments of everyday life. Better to trust time, resilience, support and stress reduction.”
Just three percent of DSM disorders have proven biological causes, while the origins of the rest, including depression, anxiety, schizophrenia, ADHD, bipolar and personality disorders, remain uncertain. The theory that mental illness arises from chemical imbalances, as in the notion that depression originates in a serotonin deficiency, lacks empirical validation. There is a big difference between being stressed, sad, or shy, and being mentally ill. In reality, serious mental illness is concentrated in around six percent of the population.
Western society encourages choices that promote mental suffering. The promises of secular, consumer society – happiness, prosperity, and blissful relationships – are fraudulent, and society is characterized by frustration, futility, anxiety, anger, cynicism, and despair. We have lost the ability to live in community, as is proven by family breakdown, the erosion of friendship and neighbourliness, increasing social dysfunction, and the scourge of loneliness.
Why would people not be stressed given the demands of the 24/7 workplace, suffocating digital connectedness, widespread narcissism, and the lack of compassion in corporate life? Burdened by such misanthropy, people have to wrestle with neglected domestic relationships, the incessant interference of media, marketers, and bureaucracy, and the deceit of politicians.
Absenteeism, depression, anxiety, apathy, cynicism, lack of motivation, and myriad distractions all plague business, and the line between them and mental health can be fuzzy. This presents managers with challenges they are poorly equipped to deal with.
Yet it is still possible to be a leader in these circumstances. People who have trouble thinking rationally about life certainly need professional help, but most people do not. Most simply need love and compassion, recognition and encouragement, forgiveness and wise counsel, growth in the virtues, expanding knowledge of reality, and a firmly grounded belief in Truth, Goodness, and Beauty. And all leaders can promote these essential human goods.
The most successful form of psychotherapy is a modern repackaging of these truths. Cognitive Behavioural Therapy echoes the wisdom of classical philosophers who understood that people often view life through the distorted lens of emotion and desire. CBT is the most respected non-pharmaceutical treatment of mental illness, and is as efficacious as antidepressants for anxiety and depression.
CBT is easy to understand and can achieve rapid results. The aim is to define reality as it is, and not as it seems through the filter of negative emotions. By learning to identify common cognitive distortions like negative filtering, discounting positives, catastrophising, over-generalising, and others – which merely reflect old insights like “don’t make mountains out of molehills”, or “don’t put words in other people’s mouths” – one can recognize the source of troubled feelings and defuse them.
CBT is simply the proper process of education, expanding knowledge and building character by means of critical thinking skills. Shaping one’s worldview according to reality, and cultivating virtue, is the road to personal and communal integrity.
Andre, one of the very best articles I have read in a long while. Thank you.
I certainly note a lot of what you covered appears in the youth I work with. The book you mentioned we should all read as leaders “The Culture of Narcissism” elucidates this topic but your article summarises it perfectly