Foul whisperings are abroad. Unnatural deeds
Do breed unnatural troubles: infected minds
To their deaf pillows will discharge their secrets:
More needs she the divine than the physician.
–Macbeth Act 5, Scene 1:
TO SAY LEADERSHIP is about psychology is like saying the Internet is about information. Leadership is about people, and therefore it is about psychology, which studies personality, character, motivation, emotions, attitudes, socialization, morality, how we learn, and how we think. And since psychology is a science in crisis, it seems reasonable to conjecture that this fact might have something to do with the decline of leadership in the modern world.
This is not an attack on psychology or psychiatry – they are important disciplines that bring significant benefits. Nor is it a repudiation of the pharmaceutical industry, also the source of great good. Nor is it a denial of the reality of mental illness, which causes so much suffering. However, given claims of a mental health crisis, and the woes of a “sick society”, the question needs to be asked: what are the implications for leadership, specifically in business?
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 clinical social workers, 100,000 mental health counselors, 50,000 marriage and family therapists, 15,000 nurse psychotherapists, and swarms of life coaches, non-clinical social workers, and substance abuse counselors, are active
The answer to that complex 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. There is certainly evidence to support the view that society is ‘sick’, even if the term is seldom used with precision. 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 clinical social workers, 100,000 mental health counselors, 50,000 marriage and family therapists, 15,000 nurse psychotherapists, and swarms of life coaches, non-clinical social workers, and substance abuse counselors, are active. The percentage of people on psychiatric drugs, and the statistic of one in four Americans suffering a diagnosable mental illness in any year add further credence, while rates of narcissism, unrestrained hedonism, relationship breakdown, suicide, and often barbaric violence, are also hard to ignore.
However, these facts do not tell the whole story. Scientific progress has not only improved diagnosis but has also spawned the growth of vested interests in an ever-expanding market. Research demands funding, which also generates commercial interests, drug companies need sales, practitioners need patients, bureaucracy needs dependents, and politicians need votes. Mental health is big business. Closely related to all this are the problems of the mental health profession. Let us leave aside the often sordid details that litter the well-documented history of psychology and psychiatry, and focus on the epistemic difficulties. The many different schools of psychology and the controversies that divide them indicate that there is a great deal about which the profession remains uncertain, and many practitioners resort to eclecticism, drawing insights from all sides. There is no consensus on what mental conditions are real, what symptoms indicate, what can be cured or controlled, what mental health actually means, and much besides.
The various theories relating to personality, and the confusion of therapies flowing from them only make matters worse. Moreover, practitioners are often ill-equipped to empathize with the different worldviews that shape the attitudes and behavior of their patients. They too frequently, and quite unscientifically, identify such beliefs as neuroses. As Wittgenstein explained in Philosophical Investigations: “in psychology, there are experimental methods and conceptual confusion.”
Jerome Kagan, emeritus professor of psychology at Harvard laments the fact that researchers, beguiled by technology and reductionism, ignore the culture, socio-economic circumstances, and life experiences of patients.
Meaning and purpose are as basic to psychology as genes to biology, and it is mad to assume that concepts like depression, fear, and stress, can be studied without reference to the contexts in which they occur. Firm ethical beliefs and the confidence inspired by living in a just society are vital for mental well-being.
Kagan decries the diagnostic inflation encouraged by 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. Truckloads of research dollars spent seeking a causal nexus between mental illness and neurotransmitters have yielded no definitive answers. Subjective judgment remains the driver in psychiatric diagnosis. Given these facts, even many professionals deem the statistics risibly high. 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.
As to the question of postmodern culture, it was Jules Henry who observed, “Psychosis is the final outcome of all that is wrong with a culture.” And inevitably, culture is reflected in the character of the individuals who make up a given society.
Western society makes choices that promote mental suffering. The promises of secular, high-tech, consumer society – happiness, prosperity, and trouble-free relationships – stand exposed as fraudulent, and society today is characterized by frustration, futility, anxiety, anger, cynicism, and despair. People have all but lost the ability to live in community, as seen in the breakdown of marriage and the family, the fading of friendship and neighbourliness, the slew of social dysfunction, and the scourge of loneliness.
Of course, people often think and act in ways that are harmful, and in days gone by, the word for such attitudes and behaviour was sin. However, secular society scorns the religious prognosis, and obedient to its mechanical worldview insists the problem is just a malfunction in the machine. It’s out of order, and the disorder needs to be fixed by medical intervention. Positive psychology and tools for “measuring” happiness now have governments and corporations believing they can achieve the Enlightenment dream of a scientific utopia, where the happiness of all will be engineered. And so we have marauding hordes of motivational speakers chanting the mantra of “happiness as personal choice”, with the sinister implication that sufferers are the cause of their own misery. Corporations appoint Chief Happiness Officers and call in happiness consultants to impose joy on the masses.
Why would people not be mentally distressed given the demands of the 24/7 workplace, suffocating digital connectedness, the narcissism of peers and management, and the lack of compassion in corporate life? Burdened by these misanthropic developments, people have to try and salvage their neglected domestic relationships, contend with the incessant interference of media, marketers, and bureaucracy, and do their best to rein in the cynicism unrelentingly fuelled by deceitful politicians. Their distress is understandable, to say the least.
Alarming rates of disengagement now hamstring business, costing the US around $550 billion annually. Absenteeism, depression, anxiety, apathy, ennui, cynicism, lack of motivation, and myriad distractions, all manifest this disengagement, and the line between them and mental health conditions can be fuzzy even for qualified health professionals. This presents managers with constant challenges that they are poorly equipped to deal with.
Is it possible to be a leader in these circumstances? The answer is an emphatic yes. People who for some reason or other have trouble thinking rationally about life, and making rational choices, almost 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 the transcendental realities of Truth, Goodness, and Beauty. And all leaders can promote these essential human goods.
Ironically, the most successful form of psychotherapy is little more than a modern repackaging of these truths. Cognitive Behavioral Therapy builds on the wisdom of classical philosophers who understood that most people tend to view life through the distorted lens of emotion and desire. CBT is the most widely accepted non-pharmaceutical treatment of mental illness, and is as efficacious as antidepressants in treating anxiety and depression, and even better, in that the benefits can continue after therapy ends.
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 echo old wisdom 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 rather than letting it be distorted by emotion and desire, is the road to personal and communal integrity.
Virtuous attitudes like prudence, honesty, justice, courage, compassion, and self-control, once cultivated in homes, schools, and communities, promote mental health, while harmful attitudes like foolishness, dishonesty, injustice, cowardice, malice, and licentiousness, breed mental suffering. Consider this in the context of a society that celebrates promiscuity and pornography, activities that violate every virtue, and the roots of our malaise are exposed.
Leadership entails the responsibility to promote mental health, whether in the home, school, workplace, or community. To shirk the responsibility is to fail in the first commitments of leadership – security and justice – because mental suffering is the Trojan Horse of civilised society. You must make your domain an oasis of sanity in the wilderness of despair by inspiring a strong sense of purpose, higher expectations, civilised standards, enthusiastically embraced obligations, mutual respect, compassion, and an unshakable feeling of belonging.