Medicalizing Poor Political Leadership, Part I
VTR Date: March 26, 2011
Lord David Owen discusses illness and heads of state.
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GUEST: Lord David Owen
AIR DATE: 3/15/11
I’m Richard Heffner, your host on The Open Mind.
And my guest today is Lord David Owen, an English physician … a neurologist and student of psychiatry … and a politician as well — a member of Parliament for 26 years, a founder of the Social Democratic Party, and, under Labor governments, Navy Minister, Health Minster and Foreign Secretary.
Now, in his Praeger book, In Sickness and In Power, Lord Owen writes that he has been particularly “interested in the effect on the course of history of illness in heads of government.”
He might have written: “Illness in the heads of heads of government”. For over the past century alone Lord Owen refers to seven American Presidents some have considered to have been mentally ill while in office: Theodore Roosevelt, William Howard Taft, Woodrow Wilson, Calvin Coolidge, Herbert Hoover, Lyndon Johnson and Richard Nixon.
Then, of course, there is Lord Owens’ intriguing new diagnostic category: The “Hubris Syndrome”, about which he and Duke University’s Jonathan Davidson recently wrote in “Brain” the Journal of Neurology, and which they question as a possible acquired personality disorder, reminding us of what Lord Acton, my guest’s fellow Peer of the Realm, so famously proclaimed, that “Power tends to corrupt, and absolute power corrupts absolutely.”
And so I would ask Lord Owen whether his insights here are the same … perhaps equally House of Lords-driven.
OWEN: Well, I think they are. I was looking up the quotation of Lord Acton, which you got right, but a lot of people tend … don’t use the word “tends”. And a man was standing by me and he said, “You know there’s another interesting part of that quotation?”
So I say, “Oh, Yes? Yes” and he turned over a few pages and he read out how Lord Acton had said in the same essay that you should judge Pope and King and people in power by a higher standard. And there was a tenancy to drop your standards.
He said, quite the reverse, you should judge them by a higher standard. So I said to him “How do you know about that”?
“I am Lord Acton” he said.
OWEN: (Laughter) And I hadn’t recognized him. I go to the House of Lords so infrequently that it was an interesting … but it’s a very thoughtful essay, actually, not just that famous dictum.
HEFFNER: But about that dictum … how did you come to make that as the basis for your Hubris Syndrome?
OWEN: Well, I think you … the Greeks, after all, really coined the word … “hubris” and often followed by “nemesis”. I’m a Greek-a-file, I have a house in Greece, I’m, I’m a great student of Greek mythology.
And, for example, the best history I think of Hitler, by Professor Kershaw, of Sheffield University has the first volume as Hubris … up until 1936. And then from ’36 to ’44, ’45 … Nemesis.
And I think one … sometimes it’s easier to look at a syndrome which affects famous people and give it a historical name or a Greek name. I mean some people say it’s very similar to Narcissistic Personality Disorder. I don’t think it is quite the same, but try getting a head of government or a captain of industry or a big banker to accept that they have Narcissistic Personality Disorder. You won’t get very far.
Whereas Hubris has a sort of slight touch of where it’s a little more acceptable. (Laughter)
HEFFNER: Is it acceptable, is the syndrome, the concept … acceptable to your colleagues in the profession, the medical profession?
OWEN: Not quite yet. When I first started writing about it, five years ago, they were very hostile. And it was thought you couldn’t have an acquired personality disorder … because this is a syndrome which is, you know, a collection of signs and symptoms which you’re more likely to see together than apart. It doesn’t necessarily mean it’s a disease.
But they didn’t believe that Personality Disorders could be acquired. Now you may remember the medical profession spent 20 or 25 years arguing about Post Traumatic Stress Disorder. And eventually they did accept it. Well that’s an acquired personality disorder.
So the breakthrough has come and there are number of other elements of personality disorders that clearly have their … an acquired element.
And this if … is an acquired … illness or disorder … call it what you like. Now if that is the case and it only comes with power, then you ought to see a debate quiet down … even disappear … when the person loses power.
Now I’m watching with great interest your President George W. Bush. Because I think he did acquire it, after 9/11. That was a very traumatic episode for a President to have, you know, this appalling incident happening in … not just in New York, but in Washington and the whole threat to it.
And I think there are signs. I mean I have not … yet to see a President retire so quietly and so generously … extremely generous to Obama and not critical.
Now I notice he’s coming out with a new book. So I think that the man who stood on that aircraft carrier off the California coast and proclaimed “Mission accomplished” in Iraq in 1973 … they don’t come more hubristic than that claim, when the war was beginning to rage inside Baghdad. He seems a different person now. And I’m interested in that.
HEFFNER: How do you explain that?
OWEN: Well, that would be …
HEFFNER: The absence of power?
OWEN: The absence of power. That he is now more relaxed. He has gone back to his … to Texas … he, he seems to be able to live without the trappings of power, he doesn’t have to.
Whereas Blair, Tony Blair, our former Prime Minister is running around the world trying to pretend he’s still powerful. And endlessly going on television, writing books, doing tremendous hyperactivity. And he’s obviously not accepting that he’s no longer a power in the land. And his hubris seems to be as high as it’s ever been.
HEFFNER: But you know, I wondered, as I read In Sickness and In Power … Illnesses in Heads of Government During the Last 100 Years … it’s quite an extraordinary volume. And yet I wondered whether you were really referring to political power or could you write the same thing about power in any other area?
OWEN: I could do it … I, I don’t think I could … rather, somebody is … people are starting to do it about the banking crisis. I mean some of the people who’s companies were appalling run and collapsed or were saved by the American government or the British government or elsewhere around the world … many of them, not all of them, but many of them clearly had what I would call “Hubris Syndrome”.
They were unchallengeable in their business. They ran them autocratically. They were not taking account of any form of caution and there was deep seated hubris. And you can also find, if the chief executive, or the head of an organization has personal hubris, it can spread to the company. It can spread to the organization and you get collective hubris.
And I therefore think it is very important. These people create havoc, you know. And we need to be much more open about it. People find it very difficult because they’ve just been out to dinner with them and they’re very nice and pleasant and sociable people. They’ve often been appointed by … in a fairly open form of appointment.
But slowly, often quite gradually, they acquire these attributes of a person who power goes to their head. What Bertrand Russell called the intoxication of power. I think it’s a wonderful phrase. Almost as good as “hubris”. (Laugh)
HEFFNER: But isn’t that intoxication of power … isn’t it … in your hands, sir … doesn’t it become the medicalization of poor leadership?
OWEN: That’s a reasonable criticism … and after all, most people go into politics, they are pretty hubristic anyhow … including me. You know, I’ve got quite close to this … I’m, I’m … it takes one to know one. (Laugh)
And it is a heady thing. You do have power and it is very easy after you’ve been in power for a year or so, you think you know all the answers and it’s easy to become deaf to contrary advice. And you build a little clique around you and there’s a sort of isolation that goes with power. So you look for, also, what are the reasons why powerful people sometimes don’t get it. And that I think is almost as interesting. And I think a very important influence on some people is their wives.
Clementine Churchill wrote to Winston Churchill in July 1940 … a letter. She said, ‘”I’ve torn up three copies, but I’m sending you this letter, Winston, because you’re contemptuous …” using that word which the Greeks highlighted in “hubris” … “and you’re not listening to anybody and people are stopping giving you advice. And I’ve got used to people liking you and they’re clearly not enjoying working with you. And you’re losing lots of sensible advice”. A wonderful letter. I said to my wife … “Why didn’t you write me?”
OWEN: She said, “I was telling you it all the time”. (Laughter)
OWEN: And I think that is … and I’ve often … you know, I, I’m interested in Franklin Roosevelt, who I think is the greatest politician of the 20th century because he was not only like Churchill a considerable war leader, but he was also a very great leader in a time of recession.
But I was always worried by this time when he packed the Supreme Court … was that a moment of hubris? And this recent book that’s come out in America … Supreme Power, which I think has been on your program … the author … I think shows he didn’t have hubris. I mean he took it on the chin, actually, when, having got, you know, all these Democrats in the Senate, they turned against him … and he had humor and cynical humor … and I think cynical humor is a … also a deep, I think, underlying Roosevelt was a great Democrat. And I think that’s … Churchill also had that quality. So neither of these two men, who in many ways were very hubristic … I ever think … I, I don’t t they ever got Hubris Syndrome.
Nor did I think … and of course, this is the other problem … I doubt they had bi-polar disorder or what we used to call “manic depression”.
And that’s what you have to guard against. So it’s always complex. Churchill had, of course, quite serious depression. And some people think he did have bi-polar disorder. I don’t think so. There’s no overt manic episode. You could say he was always manic (laughter). But I don’t think so.
HEFFNER: You talk about the troubles that such people can get us into. And, of course, that’s, that’s … you make that quite clear in, in your book.
What then does one do to guard against it? An inoculation? A vaccine?
OWEN: (Laugh) Well, I think let’s look at it most in business, because there are many more serious big, powerful business leaders. I think on a public board, the independent directors, one of their main tasks is to make sure that the chief executive, who often they appointed, doesn’t get carried away by his power and position. And I think that is one of their central tasks.
Also, if you’re looking at young people coming up through the company, they often have hubristic traits. Now some of those are very good things. I mean the trouble with this is it’s … there’s one side of the coin which is bad or, or creates problems. One side which is good and yet creates great opportunities for the company.
So mentoring is another way. If you spot somebody with hubristic traits … try and get them to understand that it must be contained, that they must guard against it. That there are strengths in their risk taking. There are strengths in their assertiveness, even … but there are weaknesses and they’ve got to be on their own guard against it.
And I think sometimes you don’t have to be a psychiatrist to do this or a, an analyst … it can be a fellow business person, perhaps slightly older than you who you respect, who points out to you, gently, and sometimes perhaps a little toughly, that you have these good qualities which can easily run away with themselves.
But underlying it is also … nags away at me … because when my … my younger days … when I was just qualified as a doctor, I was a research worker into the chemistry of the brain. And I think it will prove to be something which is … has a neuropharmacological basis … acquired personality disorders.
HEFFNER: Then if we do indicate that … if we do discover it … not discover … if we do … shall I say “prove” or demonstrate your sense that there’s a chemical change that takes place. What do we do about it when we’re back into the world of politics?
OWEN: Well, it’s pretty difficult to get a President or Prime Minister to accept that they have this and one way, I think, is to make them more open and honest about their illnesses.
I mean that book, which I wrote, three things come out of it. Absolutely clear … over 100 years. First … politicians lie about their illness … most people say, “Well, what’s new about that?”
Secondly and perhaps more interestingly … their personal physicians lie on their behalf.
And thirdly, and worrying for all of us … this secrecy that surrounds their illnesses means they end up of with rather poor treatment and as a consequence we all suffer because sometimes their illnesses, continuing in office, are very damaging, you know. And I think that these are things we should look at.
One thing is, which your … America is much further ahead than anywhere else in the world … they must, before they go out for elected office … be level with us about what, if any, illnesses they have. And now it’s pretty hard for a Presidential candidate not to reveal their past medical history. And I think that’s extremely important.
Senator McCain up against Obama, did eventually reveal details about the melanoma that he’d had. And prior to that, when he was being chosen within the Republican Party, when he was up against George W. Bush, he did reveal his medical records as a Vietnam prisoner of war. Now I think that’s admirable. And, you know, we must encourage that.
HEFFNER: And if we had been at that point in 1932, when your hero and mine, Franklin Delano Roosevelt, was chosen by the Democrats. If we had known the extent of his incapacity … what then?
OWEN: Well, you see … I think this is the fascinating part … why this issue is so complicated. I mean I think Franklin Roosevelt was made by his polio.
Now, I mean, he was always an exceptional person. He had a very good brain, there’s no doubt about that. And he, he was not a playboy, but there was a certain element, which was not wildly serious about him at one time in his younger life, as I read the history …
OWEN: … that you … I hesitate to say this in America when you obviously … you know him much better than I … but I think that his courage and struggle in overcoming his poliomyelitis made him a much greater man and a much bigger figure.
Kennedy is another example of this. I mean Kennedy’s Addison’s disease was very serious. He covered it completely up … but it’s hard to take it away from his life. I mean his struggle to overcome his Addison’s disease … the courage with which he put up with some of the side effects of the replacement therapy he had … almost certainly causing some of his back problems … osteoporosis of the, of the spinal cord, not just a slipped disk, probably almost certainly that he was getting adrenal supplements … in those early days in the late 1930’s was at the back … was the problem of his back illness. But Kennedy himself …
HEFFNER: Did you …
OWEN: … is an extra … I mean there’s a chapter in my book about Kennedy …
HEFFNER: And it’s a fascinating one.
OWEN: And I think it’s a more honest account than most Americans will write …
HEFFNER: A frightening chapter.
OWEN: Well, a frightening chapter.
HEFFNER: … your chapter.
OWEN: I mean … he was out of control. When he first became … his first six months as President of the United States … none of his doctors knew what the other doctors were giving him. He was under the treatment of this quack doctor in … here in New York … who was called “Dr. Feelgood”, who was pumping him full of amphetamines and steroids. Whereas his endocrinologist, who was very well recognized and good doctor was carefully judging the amount of steroids that he should get, quite unbeknownst to him these other injections and the Bay of Pigs fiasco … I have little doubt that if we had not seen by the summer and autumn of 1961 a control of Kennedy’s medication and stop taking quite a lot of drugs he should never have dreamt of taking … he would never have handled the Cuban Missile Crisis in ’62 as, as well as he did.
I mean it was a very … I mean I … it’s hard to criticize the considerate, careful way … the way he ignored the advice of the generals like Curtis LeMay who wanted to bomb Cuba. And the way he took the Executive Committee through painstaking decisions allowed Kruschev a little leeway to be able to not lose face … it was a fine performance.
But he was very different in his mental condition and what drugs were going through his body than the year before.
HEFFNER: 1960 … if you had been a member of a medical commission …
OWEN: MmmHmm …
HEFFNER: … examiningg the candidates for President of the United States … what would you have done in terms of John F. Kennedy?
OWEN: I would like to hope and believe that I would have said, that you can be President with Addison’s disease. That we have medical treatment … replacement therapy by 1960 had reached a stage where there was no reason that that of itself was a decision to exclude you from being President.
But had he come up front with it, would he have beaten Nixon in that very tight election?
Now my wife is American and she voted for him … the first time she voted. She says I’m quite wrong. She says if he’d admitted he had Addison’s disease he’d never have been elected. And when I say, “Well …”, she says, “Maybe now … we’re, we’re much more relaxed about medical illnesses, we know more about it, we’ve taken away some of the secrecy about it.” She said, “Maybe now Americans would vote for a President with Addison’s disease.”
So I think Kennedy couldn’t have sprung it on the electorate, he’d have had to explain it all through the fifties, that he’d had Addison’s disease, he was being treated. And he was a genuine war hero. I think it’s quite possible he could have won the Presidential election. But … well, what do you think … you’re …
HEFFNER: I think you wife is much more realistic and ….
OWEN: Well …
HEFFNER: … and I think …
OWEN: … I fear you’re right. (Laughter)
HEFFNER: … she might have said the same thing about FDR. Because his paralysis, his inability, really, to walk, and, and some of that … much of that comes out here …
OWEN: Yeah … you see I think …
HEFFNER: You want us to have been wise enough to have chosen him.
OWEN: Yes. I mean he did … for a lot of people. And … wasn’t there almost a business … they knew he had polio, but they didn’t want to believe it. So they … when they saw him standing there with his son beside him or a colonel in the Army holding … just steadying him … they wanted to believe that they had a vigorous … but they knew in their hearts he had polio … most people in America … don’t you think?
HEFFNER: Ah, no. I, I, I …
OWEN: You don’t …
HEFFNER: … I, I really don’t think that …
OWEN: I see.
HEFFNER: … since he was my President …
OWEN: Yeah. Well, I ….
HEFFNER: And look at the most recent matter of … profound argument over the memorial park in Washington …
HEFFNER: … whether he should be seen in a wheelchair …
OWEN: It was President Clinton who decreed that he should, didn’t he? Yeah, now … I, I … that’s being … political correctness … taking it too far, I think.
But I, I mean it’s a way of reminding people that you can over come disabilities, so I’m a bit torn. As a doctor, if I suddenly become a doctor again, I want to get the country to believe, the people to believe that you … disability must not be the stopping of a career. That, that great things are done by people who are disabled.
People who have epilepsy … the old fear of epilepsy … as a neurologist I used to spend my whole time trying to persuade people that this is no bar to taking any job. And I think that … I’m, I’m by nature an optimist, as you may have already gathered.
HEFFNER: I gather.
OWEN: (Laughter) I think … I think you’re probably right. Well, you’re certainly, I think, right over Kennedy. And maybe … of course, I’m too young to remember … I mean I remember Roosevelt as a war time President, but I was a pretty young boy.
HEFFNER: I, I … going back to Kennedy … I’m interested in what you say about the state he was in, and you talk about the drugs that he was receiving and the drugs that he took … the recreational drugs …
HEFFNER: … you then go back to the matter of his basic illness and that you would not feel that that was a bar to his being President. But if you were to put behavioral patterns … recreational drug use, etc., together, would you say … stamp of approval?
OWEN: Well the recreational drug use was not very good. There are two … I mean there are a lot … also people talk about his sex life. Now I don’t think that matters. But there were two relationships with women which were serious. And one was effectively a Mafia gangster’s moll … who he had a long affair with … well, not a long affair, but an affair while being President … and the other was a East German …
OWEN: Yes, a spy. And he was warned off by the FBI. And he took a little bit of the advice over the Mafia moll, but only, only after some months did he give it up. And on the East German, some people say she was Ulbrecht’s … the President of East Germany’s … worked in his private office.
That was pretty dangerous. I mean we were at war, effectively, with the Warsaw Pact and East Germany was a Communist country in those days.
HEFFNER: So, if you …
OWEN: That was irresponsible, there’s no doubt about that.
HEFFNER: And how does irresponsibility and I’m getting the signal we have a minute, perhaps, left … how does irresponsibility enter into the medicalization …
OWEN: Well, that is the weakness of hubris. I mean why we can’t be casual about it. Irresponsibility leads to dangerous decision making. And decision making which is not properly weighed. And I think both Blair and George W. Bush had Hubris Syndrome and one of the explanations for the fantastic mess that was made … particularly after the military success of the invasion … but in the aftermath of Iraq goes down to two of the key politicians who didn’t get into the detail, didn’t get into the serious nature of what they were doing. Didn’t seem to realize what they were going to … the havoc that was going to follow … unless they had carefully worked it out. And they didn’t’ work it out.
HEFFNER: And you’re not willing …
OWEN: So it was irresponsible …
HEFFNER: And you’re not willing to shrug your shoulders and say, “Well, that’s what goes with the territory of a democratic selection”.
OWEN: No. I think we need to find ways of stopping our political leaders being in that position. And in both those cases I think with a greater recognition of the dangers of this … we could have found that they wouldn’t have behaved in the way they did.
HEFFNER: Lord Owen, thank you … so much … for joining me today in this discussion …
OWEN: Thank you.
HEFFNER: … but you’ve promised to sit still … and we’ll do another program, because the subject merits much, much more. Thank you.
And thanks, too, to you in the audience. I hope you join us again next time. Meanwhile, as an old friend used to say, “Good night and good luck”.
And do visit the Open Mind website at www.theopenmind.tv
N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however, be a verbatim copy of the program.