24 In sickness and in power

Parliamentary House of Lords, London Lord Owen is a doctor by training and was neurology and psychiatric registrar at St Thomas’s. Hospital, London, before becoming a Research Fellow. He then entered politics and in Labour Governments served as Navy Minister, Health Minister and Foreign Secretary. He co-founded the Social Democratic Party and was its leader from 1983–1990. From 1992–1995 he served as EU peace negotiator in the former Yugoslavia. He now sits as an independent social democrat in the House of Lords. He strongly opposed the Government’s Health and Social Care Act 2012 believing it to be ‘fatally flawed’. His book The Health of the Nation. NHS in Peril was published in 2014. From 1995–2015 he had business interests in America, Russia and the UK. Lord Owen has long been interested in the inter-relationship between politics and medicine and has written extensively on the subject including In Sickness and In Power: Illness in Heads of Government, military and business since 1900 and The Hubris Syndrome: Bush, Blair and the Intoxication of Power. He is Chairman of the Daedalus Trust charity, which promotes multidisciplinary research into personality changes associated with the exercise of power in all walks of life. Other publications include his autobiography, Time to Declare (1991); Time to Declare: Second Innings (abridged and updated, 2009) Balkan Odyssey (1995); The Hidden Perspective. The Military Conversations of 1906–1914 (Haus, 2014), and Europe Restructured. The Eurozone Crisis and the UK Referendum (Methuen ebook, 2015). His latest book published in 2016 is Cabinet’s Finest Hour. The Hidden Agenda of May 1940 (Haus, 2016). The sicknesses that heads of government have either brought to office, or developed while occupying high office, and the consequences of being ill for the business of government are a fascinating study. David Owen, who has long been interested in the inter-relationship between politics and medicine, has studied in depth the effect of physical illness on such political personalities as Sir Anthony Eden at the time of Suez in 1956; John F. Kennedy and the Bay of Pigs fiasco in 1961; the last Shah of Iran; and President Mitterrand of France who suffered from prostate cancer. But within his book In Sickness and in Power, there is another interesting and far from uncommon phenomenon to which leaders in all walks of life are susceptible, including the military and business. That is how the very experience of holding office seems to develop into something that causes them to behave in ways that, on the face of it at least, seem symptomatic of a change in personality. The phenomenon of something happening to a person’s mental stability when in power has been observed for centuries and the causal link between holding power and aberrant behaviour was captured by Bertrand Russell in his reference to “the intoxication of power”. Power is a heady drug, which not every leader has the necessary rooted character to counteract. To do so requires a combination of common sense, humour, decency, scepticism and even cynicism that treats power for what it is – a privileged opportunity to influence, and sometimes to determine, the turn of events. Although hubris may be associated with leaders’ personality traits such as narcissism (including grandiosity, see Pincus and Lukowitsky, 2010) which have been widely documented and researched in management and organisation studies (e.g. Maccoby, 2004), Owen specifically describes Hubris Syndrome as a unique and acquired personality disorder that develops only after a leader has held power for a period of time, moreover it is only applicable if there is no history of psychiatric illness. The 14 symptoms for Hubris Syndrome were mapped by Owen and Davidson (Brain, 2009) against the American Psychiatric Association Diagnostic and Statistical Manual for Mental Disorders 4th edition (DSM IV) criteria for narcissistic personality disorder (NPD), antisocial personality disorder and histrionic personality disorder and serves to distinguish Hubris Syndrome from other seemingly related disorders. More recently David Owen spoke of the relevance of DSM-5 to hubris syndrome, which is now perhaps better seen as an acquired personality trait rather than a disorder. Neuroscientists can discover through brain imaging, blood and urine tests more about the presentations of abnormal personality. Physicians, psychologists and psychiatrists can all help in identifying features of hubris. David Owen is convinced only a multidisciplinary approach can be expected to provide answers on how to recognise and reduce the impact of hubris syndrome. References . Pincus AL, Lukowitsky MR. Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology2010;6:421–446. Maccoby M. Narcissistic leaders: The incredible pros, the inevitable cons. Harvard Business Review2004January;92–101. David Owen and Jonathan Davidson, ‘Hubris Syndrome: An acquired personality disorder? A study of US Presidents and UK Prime Ministers over the last 100 years’. Brain2009;132:1396–1406. David Owen, ‘Hubris Syndromeand Hubris trait’, Speech to the Royal College of Psychiatrists, 20 January 2016. www.lorddavidowen. co.uk . John Coates, The Hour Between Dog and Wolf (Fourth Estate, 2012, Penguin 2013).