The Mind of the Leader: A Psychological Primer on Leadership

By T. Byram Karasu

The Mind of the Leader is a unique book on leadership, written through the prism of a seasoned professor of psychiatry and himself a leader in his field. For decades, T. Byram Karasu has treated, advised, and coached highly successful executives and captains of various industries. Some books on leadership focus on strategies, management styles, information systems, and other technical skills. This book starts where these how-to manuals end and offers a different paradigm for leadership. With case vignettes, formal and informal encounters, and old-world uncommon wisdom, Dr. Karasu demonstrates sources of formidable successes and causes of potential catastrophic failures in leaders.

• Language: English
• Publisher: RowmanLittlefield
• Release date: Nov 2, 2023
• ISBN: 9780761874232

T. Byram Karasu

T. Byram Karasu, M.D., is the Silverman Professor of Psychiatry and University Chairman of the Department of Psychiatry and Behavioral Sciences at the Albert Einstein College of Medicine, and Psychiatrist-in-Chief of Montefiore Medical Center. He is the author or editor of more than a dozen books, including the seminal Treatments of Psychiatric Disorders and The Art of Serenity, a New York Times bestseller. He is editor in chief of the American Journal of Psychotherapy and a Distinguished Life Fellow of the American Psychiatric Association. Dr. Karasu is a scholar, renowned clinician, teacher, and lecturer, and the recipient of numerous awards. He lives in New York City and Connecticut.

Book preview

Introduction

I have written this book, through the prism of a psychiatrist, primarily to help those who are in leadership positions become more effective and successful leaders.

Over the last few decades, I have had the privilege of treating and coaching therapeutically many of the world’s most accomplished people, all leaders in their diverse fields. Most of them were extraordinarily talented, knowledgeable, hardworking, intelligent, and well-educated. These highly functioning individuals were referred to me when they were in personal or professional crises. Professional crises are the most common and most urgent ones.

I have witnessed dramatic failures and spectacular recoveries. The failures of these leaders were primarily related to their psychological fault lines associated with their psychological, social, emotional, relational, and linguistic illiteracies. The book deals with leaders’ shortcomings and my attempts to remedy them.

I received these referrals initially because of my academic background as a graduate of the psychiatric residency program at Yale. Later, referrals came because of my authorship of many books, including volumes on psychotherapy and various popular books on spirituality and serenity. I had considerable leadership experience myself. I was the co-founder and director of the Tarrytown Leadership Conference, attracting incoming chief residents from psychiatric programs nationwide and now celebrating its 50th anniversary this year. Further, I had been the Chairman of the Department of Psychiatry at Albert Einstein College of Medicine/Montefiore Medical Center for almost 25 years, and I had chaired both the American Psychiatric Association’s Commission that produced a four-volume tome on Psychiatric Treatments and the APA’s Task Force on critical review of all psychotherapies practiced in the country. Almost thirty years ago, I established a non-profit mental health organization, United Behavioral Associates (UBA) and have remained its chairman all these years. Referrals also came after a New York Times reporter interviewed me for an article on treating the wealthy and powerful.¹

Leaders, despite major differences in their backgrounds and areas of expertise, display certain prominent characteristics that hinder their ability to benefit optimally from treatment or coaching. Because they tend to be more accomplished than their coaches or therapists, leaders can put them on a defensive retrenchment by their intimidating presence, their role in society, their extraordinary wealth, their power, their arrogance, their overwhelming sense of entitlement, and their dismissive attitude. Further, leaders tend to act, qualitatively and quantitatively, similarly at work, at home, in social situations and of course, within the consultation setting.

In this book, I present vignettes of my encounters with leaders, not as diagnostic or treatment samples, but to demonstrate their common psychological impediments that prevent them from being better executives. From these vignettes, I will distill some generalizable principles for other individuals in leadership positions.

Leaders are particularly circumspect and hardly transparent about their professional lives, and it is rather difficult to extract information from them about their personal lives. Their natural tendency is to underplay their emotional problems and to overplay their own importance, their power, and their social and financial status. It takes considerable time to gain their confidence for them to reveal their real and potential failings and their limitations.

Most leaders are not emotionally accessible; they do better with a cognitive approach. Cognitive therapy, created and developed by two eminent professors at the University of Pennsylvania, Drs. Aaron Beck² and Judith Beck,³ is an effective treatment for many psychiatric disorders. The technique is also highly relevant if applied with subtlety in coaching leaders who come for advice about their professional conflicts. But leaders typically fight any attempt to imply that they may have faulty or unhelpful thinking, or any other cognitive distortion or misperception of self or the world view. Furthermore, they do not want to be patients: they rarely come with any explicit psychological complaints. They were clients who needed advice, and now! In seeking immediate gratifications, even now is too late for leaders.

A few decades ago, I was not comfortable with the role of being a therapeutic coach that involved changing my traditional therapeutic paradigm. I wasn’t even familiar with the concept, but relatively reassured by the thought that every expert must have been a beginner first. Many psychotherapists have described various evolutions in their professional lives. Psychoanalyst Salman Akhtar, in his book Tales of Transformation presents the most engaging one.⁴

There is an old saying, If the mountain does not come to the prophet, the prophet must go to the mountain. Throughout the years, I had been relatively flexible in my approach. Why was I not as flexible with these individuals? They were, after all, patients/clients looking for help on their own terms. I needed to reconsider the rigidity of my theoretical predisposition. After a while, I came to the conclusion that they were taking me out of my comfort zone. I didn’t exactly know how to proceed. I was accustomed to playing chess: they wanted to play checkers. I wanted to offer psychotherapy; they wanted advice. I wanted to control the sessions; they wanted to control me.

To be effective, I decided to play checkers as well, but without relinquishing control of sessions.

I walk a thin line in working with leaders who simply want some informal guidance. With these leaders, I am coach, therapist, teacher, advisor, friend, parent, but I am none of them. Though more complicated in its theoretical underpinning, the typical practice of psychotherapy is simpler in boundary-related issues. Even among the dogma-eats-dogma world of therapies, there are still commonly agreed-upon rules. In fact, there are no rules until you break one.

Psychotherapists who remain within the rules of the therapeutic relationship of their schools and don’t deviate too much from widely accepted techniques can sail safely. That is true at least in between crises points that are mostly of their own makings. In the therapeutic coaching of leaders, though, there are no set rules and no specific school, and certainly not a dogmatic one. There is, therefore, a wide berth of mistakes and misdeeds, ranging from bad taste to unethical behavior, to be made.

Furthermore, I am expected to be wise and engage in all subjects. This is where typical executive coaches and typical psychotherapists differ in working with leaders. In my role as a coach-therapist, I am between these two better-known practices.

Imagine a string of beads, unknotted at both ends: if you push them from one end, the beads will zigzag and not move forward; if you pull the thread from the front end, the beads will come off from the other end. One always uses one hand to do either. A seasoned psychotherapist pulls from the front end of the thread so gently that the beads roll forward; an experienced coach pushes from the back in haste so skillfully that beads move in spite of some zigzags. I use both hands simultaneously and gently make haste. Psychotherapists help their patients find their paths and follow their footsteps: I elucidate my patients’ paths and occasionally get in front of them.

Executive coaches, though well-informed about the business of the executives they are coaching, usually steer clear of subjects that are outside of their client’s business life. They limit themselves to advise executives to function more effectively in their professional undertakings.

Psychotherapists are maieutic listeners, dialoguing with their patients in the form of Socratic midwifery, and they offer an unconscious hand whenever needed. They listen and learn all about their patients’ minds, their cognitive functions, affective states, behavioral patterns, all based on their own school of therapy. By utilizing these techniques, they try to get their patients to solve their conflicts, remedy their deficits, and recover from their suffering.

Therapeutic coaching, on the other hand, is more like holistic mentoring, geared to the person’s wellness, growth, and success. It is largely improvisational, depending on the situational demands and the corresponding range of knowledge and comfort of the coach therapists.

After a half-century of practice, I am not surprised by anything and surprised by everything. To a large extent, human conditions are both unique and universal. We all have the same mind. Our ontological structure allows only minor variations. I am a human says Roman philosopher Terentius Lucanus, Nothing human is alien to me.⁵ This is a comforting statement to therapeutic coaches who work with leaders. But there are significant differences in their relationship with clients in leadership positions. In all traditional therapies the relationship between the therapist and the patient is never linear; it progresses and accumulates as in a spiral, mediated by both sides, but the therapist remains in control if she/he were to succeed. In dealing with leaders, however, this mediation heavily shifts from coach-therapist to the client, as leaders attempt to control the sessions.

Even if I manage to remain in control of the sessions, obviously, I do not attempt to control their lives. As all therapists and coaches, I am essentially pointing a direction to psychological wellness and effective leadership. I don’t literally take anyone there. Ultimately, leaders create their own personal path by living and establishing their leadership patterns.

Leaders are both like the rest of us, and not. Of course, leaders have their own lives and emotions just as everyone else. But the context of their positions differentiates them from non-leaders in the way they experience and express these psychological states.

In this book, I will convey a highly intertwined two-pronged approach as a coach and as a therapist. I will discuss segments from my sessions with leaders who had required intervention when their professional and personal lives were morphed by their personality traits and/or by their leadership positions. Psychotherapy is said to be the subtlest form of education. Psychotherapeutic coaching is less so but more complicated. I lecture patients, give advice, provide educational materials on leadership as well as on life. I try to engage leaders informally, cognitively, and emotionally through texts, stories, vignettes, and impactful one-liners—short sayings are drawn from long experiences. My goal is to make them accessible to the lessons inherent in them.

There is one more dimension to the book for the reader: witnessing my own inner monologue. I invite leaders (readers) into my inner sanctum to eavesdrop on my pattern of processing intersubjective material that evolves during certain sessions.

Throughout the book, I will use the word leader (leaders) when I write about leadership. I will use the word you when I choose to address leaders/clients/patients directly.

Although I divide the book into a number of separate chapters, they are not distinct entities. They all overlap and intertwine with each other. In presenting clinical vignettes to illustrate certain points, I have altered individuals’ names, genders, titles, and their organizations to preserve their privacy and confidentiality.

Notes

1. Eric Konigsberg, Challenges of $600-a-Session Patients, New York Times, July 7, 2008.

2. Aaron Beck, T. and Judith S. Beck, Cognitive Therapy: Basics and Beyond (New York: Guilford Press, 1995).

3. Aaron Beck, T. and Judith S. Beck, Cognitive Therapy: Basics and Beyond (New York: Guilford Press, 1995). Judith S. Beck, Cognitive Therapy for Challenging Problems (New York: Guilford Press, 2005).

4. Salman Akhtar, Tales of Transformation: A Life in Psychotherapy and Psychoanalysis (Lufkin, Texas: Phoenix Publishing House, 2021).

5. Frederick W. Ricord, The Self Tormentor (New York: Charles Scribner, 2018), 25.

Chapter 1

Cultivate Awareness

Inner and Outer Awareness

Leadership Is a Profession

There is no graduate school of leadership that gives a Ph.D. degree. An MBA degree gets as close as it gets, and not many leaders take advantage of it. Most people learn leadership on the job, painfully.

Leaders commonly are chosen from the rank of their own or similar organizations or businesses by seniority, reputation or demonstrated skills in their previous jobs. For example, a chief of a medical service may be appointed to the presidency of the hospital, or a CFO of a business may be promoted to its CEO position. But running a hospital or a business entails quite different responsibilities from the two previous jobs. Leadership of a hospital or business may be somewhat related to the old career but is entirely different.

There are many definitions of the leader. I define a leader as anyone who is in charge of and responsible for any function of a group, or even of just one person. Virtues are necessary but not sufficient for leadership. Chia Lin emphasizes the comprehensiveness of virtues as potentially sufficient: Leadership is a matter of intelligence, trustworthiness, humanness, courage, and discipline. Reliance on intelligence alone results in rebelliousness. Exercise of humanness alone results in weakness. Fixation on trust results in folly. Dependence on the strength of courage results in violence. Excessive discipline and sternness in command results in cruelty. When one has all five virtues together, each appropriate to its function, then one can be a leader.¹

Modern literature expands the domains of virtues: leaders must also have personal traits of empathy, compassion, emotional intelligence (EI), self- awareness, a moral compass, self-confidence, perseverance, sociability, and effective communication. There are hundreds of books, articles, and videos on leadership styles, modes, forms, modus operandi, and skills. These describe various types of leaderships, their advantages, and disadvantages, and they encourage readers to locate themselves and their bosses within these classifications.

These leadership styles are presented as categorical entities, almost as diagnostic classifications, with overall agreement among many authors. Some experts emphasize not the leadership styles, but the personality traits of leaders. The world-renowned psychoanalyst Otto F. Kernberg identifies key personality traits, including the level of a leader’s narcissistic integration, degree of paranoid tendencies, intelligence, and moral integrity, that greatly influence the quality of organizational functioning.² Leadership styles are primarily based on theoretical paradigms. Richard G. Darman mocked this over-used concept: Brother, can you paradigm? I ask my patients about their leadership style as a short-cut to learn about their personality traits. One’s leadership style may not be more than a manifestation of one’s personality.

Most leaders who present as patients have read at some point in their career about leadership and have some ideas where they fit in leadership categories.³ These forms and styles are either learned techniques or natural predispositions or most likely, some combination of them. Some others, almost like a religious conviction, are adamant about their leadership styles. Here are the most commonly cited ones:

Autocratic Leaders: They are pace-setting leaders who make solo decisions. They are decisive and always in need of full control.

Democratic Leaders: They are idealistic and relationship-oriented. They coach others, promote collaborations, and believe in participatory decision-making.

Bureaucratic Leaders: They operate by the book, which is written by the system. They are objective and critical, and they expect everyone to perform only the roles defined by the system, and nothing else.

Transactional Leaders: They are pragmatic and set out tasks for everyone with clear goals and timelines. They offer incentives and deliver penalties according to the results.

Laid-back Leaders: They are macro-managers who delegate everything else to their capable subordinates. They stand hands off and only interfere when needed.

Transformative Leaders: They tend to have clearly defined visions and strategies. They are almost semi-delusional in believing in themselves as much as their visions. They are paradigm changers.

Regardless of which category they do or think they belong; they all have one common trait in being coached or treated: they are all Alphas and have varying degrees of dominant personalities.

There are many other types and subtypes of leadership. Some highly successful people, with their own idiosyncratic styles and philosophies that reflect their various personalities, have written their own books. To a great extent leadership styles are manifestations of one’s personality. Because the self of the person overrides all other variables.

There are as many leadership styles as there are leaders.

I urge my clients to learn various leadership styles and techniques that are relevant to their jobs, and not to box themselves into a single category of leadership. I encourage them to become uncategorizable—to be an Omniform Leader. Such flexible leadership works, asserts Daniel Goleman.⁴ The idea of giving something a name, known as the Principle of Rumpelstiltskin, is the first step in gaining control over it.

Nobel Prize winner Isaac Bashevis Singer was once asked to which school of literature he belonged. He replied: Only small fish swim in schools.

The omniform leader is a big fish. These leaders do not fit into any of the above groupings. They use multiple paradigms as appropriate and suitable for specific tasks and changing circumstances. Intuitively, they quickly identify what sort of leadership is required and deliver