JD at the Power Clinic
The Mental Health Centre was full of hidden heroes like Antoine, a white-bearded man who had reversed his car over his infant son, and each year came back to town to remember. And Amanda, big-hearted and brave, who once crept down the storm-swept street – hiding in doorways to avoid the looming crimson mouths that ate the air – merely to warn JD of their presence. Amanda was a gallant and gifted messenger. Lawrence Mason was different, however, as he suffered from what amounted to a 'disorder of status': his madness was brought on by having power over others.
For each patient, JD had to give a clinical diagnosis and category number – otherwise, the health insurance companies would not pay. Yet it was by no means clear how she should label the man currently before her. Mason wore an expensive coat, now filthy and frayed. He was contemptuous and angry, lashing out at others and himself. Evidently, he had fallen from a great height to reach my windowless office, here, with her, this evening.
'I had whatever I wanted,' he lamented, staring at the floor. 'You should have seen my house. It was beautiful. But they took it away from me. They took it all.'
As he complained, JD drifted, noting that corruption by power – that most damaging of all human psychiatric difficulties – is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM V). Though prevalent across history and responsible for millions of deaths, it has no World Health Organisation category or corresponding numeric. Mad leaders are sometimes diagnosed in retrospect, usually to ask whether their illness impaired their judgment. Adolph Hitler, for example, is variously seen in the psychiatric literature as possibly Sociopathic (DSM #301.7) and or Paranoid Schizophrenic (#295.3). Some say he had Bi-Polar Disorder (#296.44), others Narcissistic Personality Disorder (#301.81) and Obsessive-Compulsive Disorder (#300.3). Yet none of these quite capture his boundless longing to lead, his growing self-deception and utter abandonment to evil. Most insane (male) tyrants escape diagnosis, and corruption by power of the tiny emperors across everyday life is barely studied.
'I need some water.' He glanced at her, defeated.
'Of course. I'll get some.'
Mason’s case was interesting in its stark symbiosis of personal weakness and hierarchic position. He began his career as a popular and enthusiastic member of an office supply company on the edge of an industrial estate near Swindon. Smart and hardworking, he was soon promoted and then promoted again. He took his new responsibilities seriously, yet seemed, to his colleagues, rather too sincere in his belief in the company.
Slowly, his confidence grew, as did his belief in decisive leadership. Where before he had been part of the team, now he stood above; increasingly impatient with subordinates and wearied by his responsibility. Able to cut through unproductive discussion, he made bold decisions that relied on his instincts. Indeed, in Mason's case, the capacity to dismiss naysayers and to value his own perspective over those of others was a growing source of pride in himself and alarm in his colleagues. Former friends found themselves side-lined, seen as ditherers, resistors, shirkers. At last, they used a telling everyday phrase to describe him: power, they said, had 'gone to his head.'
He bought a new car; a house; the company. 'You should have seen my villa!' he repeated. 'People wanted to be there. They took photos!' He opened a second office, divorced, remarried and invested heavily in property. When he visited the Swindon office, the old crowd tried one last time to speak to him directly. But now only he could see; only he knew what was good for them, and only he had the exceptional skills needed to run the company. Lawrence Mason's self, had, as it were, expanded. The company had been successful because of him. It now existed for one overriding and bloated purpose: to fill the void inside Lawrence Mason. Narcissism, it seems, is a brittle shell. It conceals an absence.
In his new office overlooking the river, people learned to tread with care. They knew he was afflicted. His outbursts, ever more unpredictable, were increasingly directed at those around him with the least status. If anyone disagreed with him, they risked his wrath, and perhaps being labelled as incapable and requiring discipline.
To preserve his status, Mason would commit any act of recklessness, to bend any rule and tell any lie. And all the while, he insisted it was for the good of others. He believed it, and to that distorted end, he sought to propagate his view of the world and maintain his control. When this attitude hardened further still, he became defensive and over-sensitive to any slight, real or imagined, so that at last even the smallest act of resistance drew absurdly cruel punishments. Interestingly, he always – very carefully and almost inadvertently – worked to make sure his subordinates did not gather together and talk. The very idea was abhorrent to him and fuelled his suspicions. And so, those around him spoke less. They resented him. They looked busy, and they kept their distance. Lawrence Mason's world began to shrink. By the end, he was its only inhabitant.
'What happened then?' JD was fascinated, if for the wrong reasons. It seemed that (from his clinical notes):
• His business failed when the bank called in his loans.
• He was accused of sexual assault against a student intern
• He was 'forced' to betray an old friend, who ended up in jail.
• His wife killed herself
• His daughter stopped talking to him.
It read like a country and western song. Maybe he had lost his money in a poker game and his dog died too.
One night, Mason blacked out from drink and upon waking, saw himself on television. He faced bankruptcy, legal jeopardy and the most public of failures. He shouted and wept as he described this, pounding his hand on my desk while she nodded with concern. All those he had bullied, stepped-on, abused and injured to build his empire, now sought revenge. The man before her had been arrogant and injurious. Once again, she leaned back in my chair and wondered how to diagnose him.
Corruption by power involves privileging one's particular view and devaluing that of others. Yet the progression profile of this subtle affliction also suggests a gradual separation from the world, a pulling back; so that only the obsequious are listened to, and soon not even them. As John Dewey said, 'all special privilege limits the outlook of those who possess it.' Such limitations are then subjected to a defensive hardening, an intensification so that every symbol of power and control and every petty and arbitrary cruelty now accompanies grand schemes of victory, domination and revenge.
Finally – and gloriously – absolute corruption by power is characterised by a brazen ignorance. This is why rich people are so often stupid. The afflicted have no awareness of their own corruption. As the leader becomes separated from his subjects and surrounded only by sycophants and yes-men, so too does he lose the capacity to learn and adapt. Now isolated and with all external sources of knowledge shut down, the world serves merely to confirm his delusions. Those who suffer from hubris, are not, therefore, 'lying,' nor are they cynically manipulating their environment for their own gain. Instead, they cannot see, and will need to be physically removed.
We should note, for example, how Mason holds everyone else responsible for his difficulties, never himself; how he so fervently believes his own blatant lies and how he fails to perceive the pain he causes in others. Freud (not that I'm a true believer) said something like 'a disorder of mind brings despair to the self, but a disorder of character brings suffering to others.' So, we are talking here about a Personality Disorder, a life-long style of character, one of budding tyranny and gradual stupefaction.
Mason railed against his enemies, barely noticing her at all. It was growing late, and the air was thick and hot. She observed the wild oscillations of his mood, which swung from morbid self-pity to aggrandised mania. There must, she thought, be something pathological at the heart of charismatic leadership - but soon she would have to stop playing and decide. While his gradual loss of contact with the world suggests an appropriate DSM category of Psychotic Disorder (#295), that doesn't quite catch it. As for the Type, it might carry a designating suffix of .91. This would give a new and intriguing diagnostic category of Authoritarian Disorder (#295.91): a mental health problem that works in tandem with an elevated position in an organisational hierarchy; one that colludes with rank and status to impede individual perception and restrict the exchange of knowledge.
Principle clinical indicators of Authoritarian Disorder (#295.91) would be (for an individual in any organisational setting):
1. Inflation of the self.
2. The devaluation of others.
3. Cult-like belief in hierarchy.
4. Lack of self-awareness of the condition.
5. A chronic failure to learn.
6. In subordinates, the disorder takes the form of willful ignorance, dependency and obedience.
Psychiatry makes no provision for the diagnosis and treatment of corruption by power. It offers no assistance to those seeking to avoid promoting or electing susceptible individuals, nor does it inform their careful management when they assume positions of authority. It is, in fact, impossible to make such a judgment unless individuals are well-known to each other. Only then can they ensure that such a person is not selected for leadership and is strictly time-limited if they are.
Of course, most gangs are, for the most part, comprised of lost souls, hungry to obey and longing for a leader to take over their thinking. But not all. Serious vigilance was shown by the populace of the Roman Republic when it was under attack in 458 BCE. The canny citizens needed the effectiveness of a Dictator to defend themselves and chose, for this task, a certain Lucius Quinctius Cincinnatus. Cincinnatus was an elderly farmer, and when the citizens came - on mass - to plead with him to lead. He declined, saying he was not interested in power. Yet this was precisely why the citizens had selected him for the role. His disinterest meant he was incorruptible. At last, they persuaded him to serve as Dictator for six months (they never allowed more), during which he saved the city. When approached by a group of young bucks plotting behind the scenes and asked to remain Dictator for longer, he refused and returned to his farm.
None of which was going to help her assign a category number to this: my most hubristic of patients. Mason had ruined people's lives and had – according to the Bible's definition of evil – 'left suffering in his wake.' Indeed, he had benefitted from it. Machiavelli was correct to claim that of all men, ‘Princes are the most dangerous,’ for they have a restless urge for power over others. Yet this particular Prince now receives his nemesis: to be sat here in this dirty office, sweating on a Monday night with JD.