No great genius has ever existed without a touch of madness.

The history of the world’s great leaders is often the story of human folly.

It’s a terrible thing to look over your shoulder when you are trying to lead—and find no one there.

The quieter you become, the more you can hear.

Noh, a form of play that originated in Japan in the 14th century, is one of the oldest existing forms of theatre. Originally an entertainment for religious festivals, Noh developed further under the protection of medieval shoguns. Noh performances are typically a combination of song, dialogue, music, and especially dance, with themes addressing human destiny rather than specific events. They often feature restless ghosts who are compelled to return to earth to retell their stories in a sacred space.

Noh plays are performed in a restrained, highly stylized manner; the actors, like Zen priests, are inscrutable, their gestures abstracted by simplification as is typical of Zen communication. Along with elaborate costumes, the actors wear masks to convey their characters. The masks help ensure that an actor’s facial expression never varies from that which the playwright intended (though an actor may change his mask in mid-performance, as dictated by the play). Along with the other components of Noh, masks help the actors concentrate on the essence or soul of the people they’re representing.

Noh is a truly timeless art form: it speaks to modern audiences as it did to the noblemen and women of a much earlier period. As indicated above, there are parallels between Zen and Noh, the former having had considerable indirect influence on the latter. Both Noh art and Zen are underpinned by imbalance and paradox. The early Noh producers and actors worked primarily for an audience whose aesthetic standards were those of Zen; and whatever may be said of the literary content of the plays, their structure and the atmosphere of their presentation were in full accordance with the canons of Zen taste.

A comparable Zen-like stylized theater, but of a very different form, can be found in Leni Riefenstahl’s Triumph des Willens (or Triumph of the Will). Presented as a film, this recording of the annual Nazi Party Congress at historic Nuremberg in September 1934 may be the most controversial documentary ever made, being both despised and admired. Considered the greatest propaganda film of all time, Triumph of the Will’s sense of spectacle made it a visual icon to Nazism. The film is not only a full-blown celebration of the power of the Nazi regime, but in particular a glorification of Adolf Hitler. It chronicles the week of events at the Nazi rally, culminating in a speech by Hitler. As with watching a Zeninfluenced Noh play, seeing Triumph of the Will is a remarkable experience, due to its artistic quality—its lyrical, dance-like cinematographic rhythm and its light and dark movements. Nazi symbols—swastikas, eagles, flags, and banners—are highlighted from different angles, making for a great sense of drama. People are blended into the background or filmed as part of a group: we see anonymous masses of soldiers marching, carrying Nazi flags, and saluting the Fuehrer. Vast faceless masses appear to be an essential part of the film’s construction; Hitler is the only nonfaceless persona—but given the way he comes across, he could be a Noh actor with a set of masks.

This black-and-white documentary, with a mastery of technique that’s both breathtaking and sinister, brilliantly captures the Wagnerian grandeur and meticulous choreography of the Nazi rally. To give the documentary real momentum, Riefenstahl opens it with Hitler descending in a plane from the skies above Nuremberg to an enthusiastic reception from Nazi supporters on the ground. From Hitler’s arrival all the way to the end, the film shows an incredibly orchestrated spectacle featuring tens of thousands of extras. This remarkable documentary takes great pleasure in the Teutonic architecture of Albert Speer, the formal precision of marching cadres, and above all, the almost religious exaltation of Hitler as the mystical personification of the dreams and ideals of his people. The film is like a love song celebrating Hitler’s charismatic talents.

People obviously believed what they saw in the Noh-like images they were shown in Triumph of the Will—believed in the elaborate glorification of a dark leader and in the staged beauty of dictatorship. The ranting of Hitler, with his frightening tirades about the glory of Germany, the stultification of people used to being addressed by blaring intonation rather than common sense—the result is a mesmerizing experience. At the end of the documentary, after Hitler has delivered an impassioned speech that stirs up his enthralled audience, admiring aide Rudolph Hess takes the microphone, points to Hitler (as if emphasizing the ultimate abdication of self), and says, “Adolf Hitler is Germany and Germany is Adolf Hitler. He who takes an oath to Hitler takes an oath to Germany!” Few people at that rally would have been able to prevent themselves from being swept away in the maelstrom of visual, symbolic, and emotional forces. The enthusiasm with which the Germans threw themselves into an orgy of violence and self-destruction is a testimony to the mesmerizing qualities of charismatic leadership—in this case, of the darkest sort.

The term “charismatic leadership” is often used to describe the compelling effect some people have on those in their employ or constituency. Charismatic leaders, like pop stars, have the ability to leave their audience spellbound and inspired. As a consequence, they have the potential to help transform others: charismatic leaders, through language, attitude, and action, help people transcend their normal way of doing things. But as the movie Triumph of the Will demonstrates dramatically—and as Zen teaching emphasizes—these charismatic, inspirational qualities can also be a cause for great concern. The shadow side of this form of leadership has been a source of inspiration for Zen masters, psychoanalysts, and leadership coaches alike. While the ability to inspire others can be used for the good, it can easily be used for the bad, as the example of Hitler demonstrates. Charismatic leaders can be like the Pied Piper, entrancing those around them and leading them to their doom. Many charismatic people engage in self-destructive behavior, and when they draw others with them, the consequences can be far-reaching and even deadly.

THE GIFT AND CURSE OF CHARISMA

In the previous chapters I’ve presented various character prototypes and discussed how personality can affect leadership style. In this chapter I’ll be looking at personality from a different angle, introducing the emotional addict—a person characterized by serious mood swings—as the latest in our personality parade. The reason for singling out this particular behavior modality is that it’s often aligned with charismatic behavior and leadership. Moreover, it’s especially common among leaders who lead their organizations and their people astray. Thus a better understanding of the psychological functioning of the emotional addict will help us better understand the psychodynamics of people in organizations.

Charisma is a special characteristic that some people, and most truly effective leaders, possess. The term charisma comes from the Greek word kharisma, or gift. Although it’s generally used to describe the ability to charm or influence people, it also has religious connotations, meaning “of the spirit” or “inspired”—that is, having God’s light shining through one. People with charisma are seen as possessing invisible energy that creates highly visible effects. Not surprisingly, as the case of Hitler shows at the negative extreme, many people feel attracted to charismatic leaders. Such leaders gather followers by dint of personality and charm, rather than via external power or authority. But what makes them so attractive can also be their downfall, and that of the people associated with them.

When we put aside charisma’s religious associations, what are some of its qualities? Why is it such a mysterious force? What makes it so special? At a purely descriptive level we can list adjectives such as visionary, energetic, unconventional, exemplary, and theatrical. We have to go deeper, though, to decode the mystery. If we adopt a clinical orientation and draw on the concepts of transference (as described in Chapter 2), the enigma of charisma becomes less murky. We then recognize that followers respond to their leaders as they would have done to their parents or other authority figures while growing up. In fact, this process is part of a general developmental matrix that repeats itself, to some extent, in most leader-follower relationships. As the past is transferred to the present in the interaction between a dynamic leader and his or her followers, it sets the stage for “charismatic attribution,” reactivating former developmental interaction patterns and bringing a hunger for idealization to the fore once again.

It’s clear that charisma can be a gift, but as many followers can attest, it has the potential to be a curse as well. As noted earlier, charismatic leaders can cause a contagion of enthusiasm and excellence. They can also trigger contagion of a far more negative sort, drawing their followers into collusive relationships. Some of the leader-follower collusions can be summarized by the term “folie à deux,” or shared madness, a form of mental contagion ¹,²,³-⁴. In folie à deux situations, both parties get stuck in a process of mutual projective identification—there’s a hefty psychological term for you!—that hampers growth and development.

Projective identification, an attempt to apprehend and influence another person’s subjective world, is a complex, subtle, almost mystical process whereby a part of the self is expelled and “deposited” into someone else. As an interpersonal process, it can be interpreted as an intrusive, primitive form of communication whereby the initiator gets the receiver to experience a set of feelings similar to his or her own. Through this process of projective identification, both parties—be it consciously or unconsciously—are drawn together. The person who does the projecting evokes in the recipient of the projection feelings parallel to the ones projected. In other words, the recipient, who then experiences similar feelings, understands the initiator ⁵.

In the case of folie à deux, leaders whose capacity for reality-testing has become impaired shift their delusions and unusual behavior patterns to their subordinates, who in turn often not only take an active part in, but also enhance, and elaborate on the delusions. The recipients of these delusional ideas start to behave in accordance with the projected fantasies (rather than simply understanding them). In some situations the initiator uses the recipient as a kind of “garbage disposal,” trying to make him or her the recipient of the initiator’s own undesired qualities.

Given the power dynamics of organizations, colleagues and followers who aren’t willing to “play” with a delusional leader aren’t likely to last. Followers who want to remain employed may need to engage in mental acrobatics to stay in the orbit of their leader; they may need to twist and stretch reality a little or a lot in order to stay close to the center of power. If they want to minimize conflict and disagreement, they must be willing to sacrifice the truth on the altar of intimacy, maintaining a connection with the leader even though that person has lost touch with reality. (The phenomenon of projective identification isn’t purely negative, however, because it forms the basis for empathy, intuition, leaps of nonverbal synchronicity, experiences of mystical union with another person, and the ability to “read” another person’s mind.)

“Mental gridlock” often occurs in situations of folie à deux, because once people fall into dysfunctional interaction patterns, they can’t find their way out. In fact, they can’t even see the rut that they’re in. Given that projective identification is an unconscious process, both leader and follower in a collusive relationship would almost certainly deny the collusion. The players lack the ability to see their relationship objectively; they can’t see that they’re trapped in a “parasitic” bond. And they certainly wouldn’t acknowledge that their collusion is a sign of arrested development, though it’s an attempt to deal with deep-seated, unresolved childhood experiences and conflicts.

A famous example of folie à deux between two individuals is found in the literary relationship between Don Quixote and Sancho Panza in Miguel de Cervantes’ masterpiece. Don Quixote, a nobleman, has completely lost touch with reality: he fights windmills that he thinks are his enemies, and he sees virtue and beauty in a woman whom society has rejected as a prostitute. His squire, at the outset a reasonable, sane man, ends up sharing the delusions of his master, becoming equally mad.

When collusive relationships, with their impaired reality-testing, develop in an organizational setting, they can have various outcomes—all negative. What starts on a small scale—the leader and a single follower—can lead to the full-blown contagion of groupthink and folie en masse. The result is typically the self-destruction of the leader, professionally speaking, and the demise of the organization. If before the ultimate “fall” some of the organizational participants recognize that the leader is out of touch with reality and sense the dangers of collusion, the endgame may include a “palace revolution” whereby the leader is overthrown.

Important as transference (expressed in an extreme way in folie à deux) is to charisma, it alone doesn’t always fully explain that phenomenon. Even among charismatic leaders there are some who stand out as especially influential and magnetic, or who at times take on a special fervor. At the root of their charisma is what psychologists call hypomania, or elation, a close relative of manic-depression. When they’re in an elevated, expansive mood state, their energetic behavior becomes even more compelling, making them highly attractive to others and thus more able to confer their perceptions and mood states on others.

Although most of us have heard about manic-depressive illness, with its devastating consequences to the sufferer and to friends and family, many are unaware of milder temperamental variants of this condition—patterns of behavior, including hypomania, that aren’t as easily identified. People whose behavior is hypomanic are prone to mildly manic states rather than the extreme highs and lows of full-blown manic-depressive illness ⁶,⁷,⁸-⁹.

THE SIRENS OF HYPOMANIA

An example will help illustrate the complex nature of hypomania. A few years ago, I received a phone call from an acquaintance, the non-executive chairman of Novorex, a large consumer products company. He was interested in talking to me because the board he headed had just forced the resignation of David O’Connor, a man in his mid-forties who had been the CEO of the company for just over three years. Initially, according to my acquaintance, all the board members had been very pleased to have David at the helm of Novorex. He had been a highly attractive candidate for the position; his charm, energy, and positive thinking had won over everyone on the board. More important, he had been full of ideas for revitalizing the company, which had been in a slump for quite a few years.

Soon after being hired by the board, David had gone on an acquisition spree to improve Novorex’s global product/ market position. Although his logic for the different acquisitions was convincing at the time, the acquisition policy soon put Novorex in dire financial straits and saddled it with a portfolio of poorly matched enterprises. The promised synergies weren’t materializing.

My acquaintance confessed somewhat sheepishly that he and the other board members felt considerable responsibility for the present sorry state of the company; they regretted not having been more vigilant in monitoring and questioning David about his moves. He explained that the board had been entranced by David’s vision of the future; his intensity, his energy, and his selfassuredness had been almost intoxicating. David really knew how to induce enthusiasm in other people, according to my acquaintance. As a result, the board had gone along with David until it was almost too late. Even after the board members had commissioned an external consulting report and learned that most of the acquisitions were lemons—a fact confirmed by the financial results and stock prices over the last two years—they had been reluctant to act.

My acquaintance explained that he and the other board members had waited so long to intervene because they really wanted to believe David’s claim that—in spite of poor financial results—a turnaround was just around the corner. However, a costly strike at their major distribution center, the result of a number of poorly executed cost-cutting measures, had convinced them otherwise. That development surely meant another year of serious losses and a further fall in the share price. With some of their larger institutional shareholders becoming vocal in their concerns, the strike had left them no alternative but to pull the plug and ask for David’s resignation.

It was clear from my acquaintance’s comments that his sense of responsibility extended beyond the company to the colleague who had been asked to resign. He implied that, by allowing themselves to be caught up in David’s personal magnetism, they had failed not only the company but the man they had hired. He felt that David, in his present state, needed some help and asked me if I would see him. I told him that I would be happy to do so. When I received a call from David later that same day, we set up an appointment a couple of days hence.

On the basis of my acquaintance’s description of David, I had expected a very different type of person than the man who kept that appointment. It wasn’t easy to recognize, in the man slumped in my office chair, the energetic, self-assured individual I had heard described previously. As a matter of fact, David made exactly the opposite impression: I saw a person who felt sad and empty, who had little interest or pleasure in anything. When I probed a bit, David complained about his inability to sleep, his loss of appetite, and his general sense of fatigue.

David explained his present mood state as a consequence of his dismissal. Having had time to reflect on the matter, he acknowledged that the board’s decision wasn’t completely unreasonable—an acknowledgment that grieved him. His behavior and actions may have given them cause, he admitted: his acquisition policy may have been too bold; he may have painted too optimistic a picture of the expected results; he may have been a bit too cavalier with the figures; he maybe should have heeded the advice of some of his more “sober” executives rather than attempting to sweep them away with his enthusiasm. He confessed that he had ignored a consulting report that showed more depressing numbers than the ones he had presented to the board, and had rationalized the dramatic fall in share price as just temporary.

Though David described his mood state as rooted in his dismissal, it soon became clear from the conversation that he had been prone to mood swings since childhood. He mentioned that there had been many periods in his life when he had been wildly out of control—dominated by soaring highs and melancholy lows. Almost a decade earlier he had consulted a psychiatrist for help in controlling his unstable behavior, and she had prescribed medication that had helped him for a time; it had made his life more balanced. However, he had found that life with lithium wasn’t as rich as life without; the antidepressant had resulted in an emotional dampening of his experiences, making his existence more “flat,” less exciting. Missing the highs of hypomania, he had stopped taking the medication, and he remained off it to this day, preferring the occasional state of euphoria (and the lows that were part of the package) to the more middle-of-the-road state he had attained with the help of medication.

David tried to explain to me how he felt when flying high. While in that state, he said, he perceived everything much more intensely. A simple thing like walking in the local park, for example, became an almost mystical experience. With all his senses fully operating, his awareness of all the objects in his environment was intensified. Whatever he did—be it looking at a tree or a flower, listening to a bird, or talking with an associate—he did more deeply.

It became clear from the conversation that David was addicted to his high moods. Being in an elevated state brought him a great deal of satisfaction and seemed to benefit his work as well. It increased his own productivity and helped him energize his colleagues and actualize the various projects they were involved in. He said that getting others excited about his ideas made him feel alive. When that high-spiritedness left him, life had a dead and deadening quality.

Upon further questioning, David mentioned that before his marriage he had been something of a Don Juan, dating a steady supply of girlfriends. Women had seemed to flock to him back then, drawn by his ebullience. While not many stayed around long, he had enjoyed their company, craving the intensified sexual feelings he had experienced when in an elevated mood state. David’s ability to attract women seemed to have had an addictive quality to it—the more women he dated, the more he felt the urge to meet new women—but it had also had a destabilizing influence, making him more prone to mood swings.

His marriage at the age of twenty-six had helped somewhat in balancing his moods. His wife had given some stability to his life. Recently, however, with the children in college, his wife had embarked on a full-time career. Their equilibrium changed as they saw less and less of each other. With his wife preoccupied with professional concerns, David began to spend more time at the office and on travel, and he had affairs whenever tempted, making little effort to conceal the evidence from his wife. Gradually, his preoccupation with other women ate into their marriage. He and his wife had been separated for over a year, but he was only now coming to realize how much the decrease in interaction with his wife had affected him.

It also became clear from the conversation that David was no stranger to substance abuse. He often resorted to help from a bottle when he was feeling up, because alcohol prolonged and intensified the euphoric effects. When asked, he denied that he was an alcoholic, but he admitted that he drank a few whiskeys each day. He also admitted that he had experimented with a few drugs, including cocaine.

Before joining Novorex, David had been the chief operating officer of another company in a related industry, working closely with the CEO—a man whom David described as exerting a stabilizing influence on his life. They had been very successful as a team, in part because their temperaments offset each other: the conservative CEO had modified David’s expansive ideas into more manageable proportions. David had succumbed to the temptations of a headhunter, however, and accepted the job at Novorex. He thought that serving as CEO would give him the opportunity to really show his worth. And for a while it had; he had been really flying—until the present crash.

The symptoms that David described suggested a relatively mild variety of manic-depressive or bipolar disorder. Bipolar illness encompasses a wide range of mood disorders and temperaments, varying in severity from cyclothymia—which is characterized by noticeable (but not debilitating) changes in mood, behavior, and thinking—to full-blown, life-threatening manic-depression. What makes the behavior of people with any of the bipolar variants unique is the cyclical nature of their illness. These people constantly swing back and forth between two opposite poles of emotion.

In the Diagnostic and Statistical Manual of the Mental Disorders, DSM-IV-Tr ¹⁰, mood disorders are listed according to their intensity. Broadly speaking, a distinction is made between, in descending order of severity, Bipolar I Disorder, Bipolar II Disorder, and Cyclothymia. True manic-depressive illness, or Bipolar I Disorder (characterized by one or more manic episodes), isn’t something to be taken lightly. The mood disturbance of the true manic-depressive is sufficiently severe to cause a marked impairment in occupational functioning and in social activities and relationships. Some manic-depressives also experience psychotic episodes characterized by delusional thinking, hallucinations, and/ or bizarre behavior. Occasionally manic-depression is extreme enough to require hospitalization, to prevent harm to self or others. Without medication, all manic-depressives have difficulty functioning normally. With medication, however, even those with a tendency toward psychosis generally don’t become psychotic. Any bouts of madness they do suffer are generally temporary, seldom progressing to chronic insanity.

Of the three bipolar subcategories—Bipolar I Disorder, Bipolar II Disorder, and Cyclothymia—it’s the latter, less severe two that are more commonly found in organizational settings. Instead of engaging in truly manic behavior, with its increasingly explosive highs and potentially suicidal lows, Bipolar IIs and cyclothymics are prone to hypomanic behavior, or “mildly” manic states.

These hypomanic episodes alternate with depressive episodes during which people lose interest and enjoyment in normally pleasurable acts and events. They may also experience changes in appetite or weight, problems with sleeping (too much or too little), decreased energy, apathy, lethargy, hopelessness, a sense of emptiness and futility, feelings of worthlessness or guilt, difficulty thinking, an inability to concentrate or make decisions, and recurring thoughts of death and suicidal fantasies. It should be noted that these mood disturbances aren’t due to the physiological effects of drug abuse or medication.

While hypomanics in the depressive state are bereft of energy, the opposite can be said of them when they’re in the manic state. It’s easy to see how executives in a hypomanic mode can revitalize and move organizations. Possessing qualities that are often described as charismatic, these people are energetic, flamboyant, and expansive. They know how to pull others under their spell with their unflagging and intoxicating enthusiasm. They’re positive thinkers, undefiable optimists in the face of adversity; for them the glass is always half-full. Furthermore, they dare to tread where others fear to go; they easily assume risks and are willing to make bold moves. They crave stimulation, novelty, and excitement. Life is filled with meaning for them: they have a purpose, and there are many things to be done. They make enormous efforts to make their dreams come true and take others with them in their search for adventure.

While they’re in manic mode, their speed of mental association, fluency of thought, elevated mood, and strong sense of well-being can be infectious, as can their sense of euphoria and their pronounced enthusiasm. They radiate self-confidence about the things that they’re trying to set into motion (although that confidence is often later revealed to have been misplaced). Their high moods bring with them a sense that everything is possible. Given that belief in ultimate possibility, it’s not surprising that following the rules isn’t their forte. They know how to beat the system, finding creative ways around it. However, they often underestimate the effort needed to get projects on their way.

Hypomanics, when in their manic state, usually have an inflated sense of self-esteem, as well as an unbending conviction of the correctness and importance of their ideas. Although this sense of conviction can be used for the good, it can also have disastrous consequences. The “I’m always right” way of thinking and behaving tends to disregard valuable alternatives and thus contributes to poor judgment; this in turn can lead to chaotic patterns of personal and professional relationships. The grandiosity of hypomanics often leads them into impulsive involvement in questionable endeavors, ideas coming so quickly that one scheme follows on the heels of another. Hypomanics are often easily distracted as well; incapable of screening out more relevant from less relevant information, they change activities as the urge hits them. There’s a certain volatility to their behavior, and they can be extremely impatient.

They’re also extremely social when manic, ready to engage whomever they encounter. Consequently, they may get caught up in intense and impulsive romantic or sexual liaisons, even with workplace colleagues. Compared to more common mortals, upbeat hypomanics seem to need very little sleep. A “good” night’s rest isn’t for them; there are too many things to be done. Because their thoughts may race, often at a rate faster than can be articulated, their speech pattern may be louder and more rapid than is usual.

What are the organizational consequences of this cluster of elevated-mood characteristics in hypomanics? The increased energy and expansiveness, the intensified perceptual awareness, the willingness to take risks, and the fluency of thought associated with hypomania often result in highly productive and creative periods. As a result, hypomanics can be a real asset to their organizations. They can be very imaginative and creative, and are generally high-achievers. As a matter of fact, a considerable body of research indicates a strong relationship between bipolar disorders and intellectual and creative achievement. A much higher than expected rate of bipolar disorders appears to exist among exceptionally creative artists and writers. One study concluded that 38% of a sample of eminent British writers and artists had been treated for mood disorders ⁸. While extreme fluctuating mood states can contribute to creative imagination and expression, the research findings also show that they can be a highly destructive force. For example, a large percentage of people suffering from bipolar disorders have a history of some kind of substance abuse or dependence. People with bipolar disorders are also far more likely to be suicide-prone.

The precarious balancing act of these people can be observed in business settings as well as in the creative realm. As indicated earlier, these people can make a major creative contribution to their organization. At the same time, their expansiveness, unwarranted optimism, grandiosity, impulsiveness, and poor judgment while in an elevated mood state can lead to the undertaking of extremely risky ventures. So caught up in their grandiosity that they overestimate their capabilities, hypomanics may engage in more activities than they can handle—more than are humanly possible. Yet they don’t take well to suggestions about cutting back. Indeed, they can become extremely irritable when their wishes are thwarted. An irritable underpinning may characterize their behavior across the board. Instability of mood, alternating between euphoria and irritability, is frequently seen in hypomanics.

The fact that hypomanics tend to deny that their behavior can be problematic complicates interactions with them; they often resist all efforts to be helped. And people who haven’t seen them in their most manic state are prone to concur, because hypomanics put on a good front; they can be very convincing in assuring others that there’s nothing the matter with them. They avoid unpleasant ideas and perceptions, along with the emotional consequences of reality—the anxiety that would overwhelm them if the warded-off depressed feelings and images were permitted to flood them—by immersion in a mood state that varies from good humor to exultation; but only the good humor is readily apparent to outsiders.

SURVIVING THE ″MANIAC″

With the knowledge gained from this excursion into the vicissitudes of hypomania, let’s return to David. What can be done to help him? What are his options? What would be the appropriate form of intervention? Generally speaking, what can be done to contain the contagion of this form of charismatic behavior before it destroys leaders, followers, and organizations?

As we consider treating this disorder, we have to take several things as givens.

Hypomania is a chronic condition; it won’t simply go away, even with treatment. In fact, there seems to be a genetic basis to manic-depressive illness, as demonstrated through studies of twins. Data from identical twins show that if one twin is manic-depressive, it’s very likely that the other, if not manic-depressive, will have a cyclothymic nature ¹¹.

Manic-depressive illness is relatively common. This is bad news, to be sure, but there’s good news to balance it.

No other form of mental disorder has been more profoundly affected by advances in neurophysiological research than the bipolar disorders. Lithium and related drugs are highly effective in controlling the devastating effects of the more serious forms of this dysfunctional state, allowing people to lead relatively normal lives. Many people have taken these medications with good results.

While drugs tend to be the first line of defense against the bipolar disorders, it’s not clear to what extent such medications—both those already in use and the many under development—limit the creativity and productivity of people with bipolar disorders. Present research shows conflicting findings on the effects of medication on creative achievement. Although it can be said that there are real problems in giving pharmacological treatment to people with mood disorders—as David noted, medication may affect their intensity of experience—the consequences of not doing so are far worse. If nothing is done about bipolar illness, there’s a strong probability that it will progress, the mood swings becoming increasingly frequent and severe. Depression may intensify, increasing the risk of suicide. Modern medicine permits relief from the extremes of despair and chaotic behavior, thereby allowing bipolars choices that they didn’t previously have.

Psychotherapy or leadership coaching in combination with medication can be a very effective means of treatment. Medication frees the person from the devastation caused by extreme depressive and manic episodes. Psychotherapy, for its part, helps the person deal with the disorder, assisting him or her to understand the psychological implications of mood swings and their aftermath and convincing him or her of the need to take medication to prevent a recurrence. Psychotherapy or leadership coaching can also be seen as a form of preventive maintenance: the hypomanic client takes steps, as a life strategy, to mitigate the expected fluctuations.

Of course, suggesting psychotherapy or leadership coaching is easier than initiating it, because hypomanics are rarely the best of listeners. While in a hypomanic state, whether up or down, they rarely have genuine insight into either their condition or how they’re perceived by others. Furthermore, as noted earlier, denial is a common defense mechanism among hypomanics—a mechanism that seriously impairs their critical faculty. Especially when they’re in an elevated mood state, hypomanics tend to deny that there’s anything the matter with them; they’re reluctant to admit the maladaptive nature of their behavior. When depressed they tend to be a bit more realistic about their abilities and possess more insight; for that reason, they’re more easily reached when down.

What can be done to help a colleague who exhibits hypomanic characteristics? Colleagues can take on the “container” role; that is, they can psychologically “hold” the person while he or she is on a high or low, reining him or her in when necessary. Executives who recognize a hypomanic among them and sense the intoxication of a hypomanic’s behavior can partner that person with someone of an especially sober mind, and they can work to create an overall executive role constellation whereby several other executives can exert a balancing influence. Colleagues can then caution the person before he or she plunges into ill-conceived business activities. Even the hypomanic who resents such warnings may heed them. In the case of the hypomanic who heads an organization, the role of non-executive board members as a balancing power is critical.

David would do well to familiarize himself with the nature of hypomania, as described in the previous pages, and to work with a mental health professional to put together a treatment package. He can begin with a couple of common-sense steps toward stability. First, given his vulnerability to mood swings, he should pace himself; the potential for drama in his life is great enough as it is. Second, in both his private and his public lives, he should avoid situations that aggravate his condition and create situations that do not.

Beyond these self-help measures, psychotherapy or leadership coaching may be of some help to David, as suggested above. Medication, while a more extreme measure, should also be considered if his severe mood swings continue. The combination of psychotherapy and medication may help him stabilize his life. Later, when he has attained a more balanced mood state, these interventions may no longer be needed. While David may regret that he no longer has the extreme highs, he will be spared the crash that follows.

To synthesize treatment modalities, David should also evolve a life strategy that allows his wife to have a balancing influence. Taking that step, while easier said than done, will likely expedite therapeutic interventions. If the marriage is irreparable, he should find another life partner—a woman who shares his wife’s “containment” capabilities and can bring him to earth when he’s flying too high. At work, he likewise needs checks and balances in the form of other executives, as I’ve noted—people who can calm him down when his hypomanic behavior takes over, who can exert a sobering influence without destroying his creative potential.

Executives caught up in the frenzy of Dionysian ecstasy dance a fine line between creative achievement and business catastrophe. Their decisions and actions, interpreted as bold and imaginative at the outset, may lead to disaster. However, hypomanics who learn from their mistakes, who nurture their reflective capacities, who are able to put on the brakes when the alarm bells ring, who create life situations that have a balancing influence—these people can be a great asset to any organization. Their capacity to dream and set high goals, their positive attitude in the face of adversity, and their ability to inspire and energize go a long way toward giving their organizations a competitive advantage.

Clearly, then, hypomania isn’t something to be obliterated. Samuel Beckett, in Waiting for Godot, said, “We are all born mad. Some remain so.” And maybe that’s a good thing. In spite of dark forces that can run out of control—voices of unreason that can lead people to ruin—it’s to be hoped that we all retain a touch of madness. And we shouldn’t hide what madness we have, because it can be the source of much creativity. But we should try to contain it. One could even argue that too much sanity is itself a sign of madness. After all, without a degree of madness, life in organizations would be pretty dull. And such dullness would lead to complacency, making us less prepared to deal with life’s discontinuities.

REFERENCES

1 Deutsch, H. (1938). “Folie a deux.” Psychoanalytic Quarterly 7: 307-318.

2 Enoch, D. and H. Ball (2001). Folie à deux (et Folie à plusieurs). Uncommon psychiatric syndromes. H. Ball. London, Arnold.

3 Kets de Vries, M. F. R. (1979). “Managers can Drive their Subordinates Mad.” Harvard Business Review: 125-134.

4 Laseque, C. and J. Fabret (1877). “La folie a deux ou folie communique.” Ann. Med. Psychologie 5 serie (T. 18).

5 Ogden, T. H. (1982). Projective Identification and Psychotherapeutic Technique. New York, Jason Aronson.

6 Fuller Torrey, E. and M. B. Knable (2002). Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families, and Providers. New York, Basic Books.

7 Goodwin, F. K. and K. R. Jamison (1990). Manic-Depressive Illness. New York, Oxford University Press.

8 Jamison, K. R. E. (1993). Touched with Fire. New York, The Free Press.

9 Mondimore, F. M. (1999). Bipolar Disorder: A Guide for Patients and Families. Baltimore, The Johns Hopkins University Press.

10 American Psychiatric Association (2004). Diagnostic and Statistical Manual of the Mental Disorders: DSM-IV-Tr. Arlington, VA, American Psychiatric Association.

11 Murphy, M., R. Cowan and L. Sederer (2004). Blueprints Psychiatry. Malden, Mass., Blackwell.