Atul Gawande, in an article for The New Yorker, writing about the soaring cost of health care, looks at the role dying and the terminally ill play in those costs:

Twenty-five per cent of all Medicare spending is for the five per cent of patients who are in their final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit. … In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality, and created a new difficulty for mankind: how to die.Technology sustains our organs until we are well past the point of awareness and coherence.

Death is the enemy. Though it’s not just death in the literal sense. Admitting defeat can be hard, and refusing to give up can cost us dearly. Whether the President or Congress continues to escalate a war in the hopes of finally turning it around, or someone stays in a troubled relationship in the hopes that things might just get better, it’s not easy to raise the white flag. (more…)

Last week the American Psychiatric Associations released a draft of DSM-V, the Diagnostic and Statistical Manual of Mental Disorders. The final version is set to come out in May 2013. It has a number of proposed revisions which have been widely blogged about, including a new diagnosis of hypersexuality. In just about every post I’ve read, at some point, the author proposes Tiger Woods as the poster child for this new diagnosis.

As a blog on power and leadership, I’ve spent a fair amount of time here discussing instances in which power goes awry, in particular, why and how public figures and leaders torpedo their careers by engaging in risky sexual behavior. How can public figures like Bill Clinton, John Edwards, Eliot Spitzer and Tiger Woods, believe their sexual behavior can be kept secret from the world?  It is easy to see it as a mental disorder and it very well may be. Undoubtedly we’ll even find the gene that’s responsible, but making this a medical disorder keeps us from contemplating it as a behavior on a continuum, one we’re all prone to. (more…)

I’m getting clearer on what this blog is about. I have started to call it, to myself at least, Learning and Leading. While leadership and power is a main focus, looking over the posts, I see that a great deal of what I write about involves the problems of learning to lead. And that reminds me of Jerry Maguire.

I love the movie Jerry Maguire, (yes, the one with the memorable one-liners like “show me the money,” or “you had me at hello”) because Jerry Maguire captures so perfectly the jet lag between knowing something and living it. One of the greatest and most frustrating psychological puzzles has to do with the difference between our espoused beliefs and our actual behavior. I’m not just talking about hypocrisy but about knowing. Just because we can think something, or even deeply believe something, doesn’t mean we know what it means as a way of being, as a day-to-day behavior. We have to learn by living it. (more…)

Remember this Nike ad of Charles Barkley?

Barkley went on:

I don’t believe professional athletes should be role models. I believe parents should be role models…. It’s not like it was when I was growing up. My mom and my grandmother told me how it was going to be. If I didn’t like it, they said, “Don’t let the door hit you in the ass on your way out.” Parents have to take better control.

This past winter, Portland’s honeymoon phase with its first openly gay mayor came to a trainwreck of an ending when the news broke (on Inauguration Day) that Adams lied about his sexual relationship with an 18 year old legislative intern.

Today it’s Edwards and his affairs. it seems each month, even week, there is another fallen angel, a politician, athlete, actor, celebrity, CEO, or person in a leadership position tumbling from a great height.

And usually at some point in the endless discussion, someone raises the point that he or she was a role model, and has greatly disappointed people.

I don’buy into this role model business. Whether or not you’re a role model is in the eye of the beholder. In which case, anyone can be a role model and not know it. if someone looks up to you, whether you are aware of it or not, you’re a role model for someone. Does that then stand to reason that you have a responsibility to uphold that person’s s image of you? Definitely not.

Maybe it’s my background in psychology but I don’t see it as the role model’s responsibility for not disappointing the one who looks up to him or her. Maturity, in my mind, requires the ability to be able to love or admire someone in their humanness, not in their super-humanness. We will inevitably be disappointed by our parents, our loved ones, a mentor. Are they at fault for not being perfect, or is it our responsibility to grapple with the fact of human complexity?

I hesitated a long time before starting this blog because I knew it would be a challenge to keep at it, even when my schedule got busy as it has these past few weeks. I knew I would just have to bear down, set my alarm for 5 am on some days, and just push myself to do it.

Pushing ourselves. This has to be one of the most interesting topics in my work with clients. When to push, when not to push. When is it injurious, even suicidal to push ourselves past limits, past fear and uncertainty, and when is it an act of courage, a needed force for change? On the one hand self-help advocates urge us to take it easy, to love ourselves, just as we are, and not only for what we do. On the other hand, we are urged to push past identities of smallness, to get out our comfort zones, and to go for our goals. How do we know which direction to take? There is no rule. Managing this inner use of power requires self-awareness.

In Deep Survival, a book exploring the psychological and biological reasons some people survive disasters and life-threatening situations, while others don’t, Laurence Gonzales writes, “the Rambo types are the first to go.” He quotes a Navy Seal commander that believing in your abilities too much can lead you to overestimate what you can do elsewhere. A certain respect for the conditions is necessary to calculate risk.

The problem with courage is that it is often used against weakness, fear or limits. We interpret difficult external conditions, or inner fear as an enemy to overcome. But courage is not fearlessness. The best warriors understand that fear is an important signal of danger, and only by listening to it do we know whether it means stop or proceed with caution. If we just push past fear, we can leave ourselves open to injury or death.

It takes just as much courage to retreat than it does to go forward. Courage can be used as a defense because we are afraid to admit defeat, shamed to fail, and hating weakness. This doesn’t take more than the most cursory reading of history to see how many follies, disasters, and collapses of empires resulted from a false sense of courage and fear of looking weak.

Sometimes courage is a suicidal impulse. When I facilitate groups, there is often someone who stands up, takes a deep breath, and says: “There’s something I have to say,” or, “This has to be said.” I cringe because I know what’s coming. Cops call it”suicide by cops:” someone kills themselves by provoking a lethal response. In groups or social settings, and increasingly on email, someone finally decides to put it all out there. “What the hell,” they think, “I’ve kept my mouth shut all this time, now I’m going to tell it like it is.”

I call this launching yourself over the edge – the force we need to get over our inhibition overshoots the mark, and we end up way out on a limb. We pump ourselves up, after having been passive too long, and blast through our inhibitions, going way past where we need to go. We do this because confuse the target of our actions with the inner inhibition we have lived with. In blasting past our inhibitions, we blast the other.

Similarly, we confuse doubts with inhibitions. We think doubts are just a sign we lack belief in ourselves. And popular psychology contributes to this by promoting self-esteem above self-reflection. While we can get past some doubts with encouragement, we can’t get past them all. This is because doubts are thoughts. Our thoughts. The thoughts we’re not identified with. We decide to go with one thought and not the others, so the unloved thought pesters us as a doubt. And the more we don’t love our thoughts, the more dissociated they become. At first they are just nagging doubts, next they come back in drag, clothed as someone else’s thoughts, “John thinks this is stupid.” This only fortifies us, and now, with an “enemy” to fight, we become even more intractable and one-sided, determined to go our own way, and prove ourselves right against naysayers. But decision making is strengthened by considering all the doubts. Bringing in all the possible problems, and truly considering them, makes robust decisions. It’s aikido – open up to the energy and force coming towards us and use it to go forward.

If we are to take the ecological crisis to heart, we have to consider sustainability as a psychological issue, not just an environmental one. What business calls the triple bottom line means factoring social, environmental and ethical factors into profits. For us, it means factoring in our psychological and physical health by having the courage to recognize limits – our own and that of others. Our bodies are like the canary in the coal mine: fear, hesitation and uncertainty are important signals that can help us create more sustainable leadership practices for ourselves and for the people we lead.

The following post begins to explore the question of abuse of power, or failures of power. In my earlier post I asked, can we learn how to use power well, like we learn how to ride a bike, or does power really have some corrupting influence? Which, if any, features related to high rank alters behavior or even personality?

A lot has already been written about the now fading scandal concerning former governor of New York, Eliot Spitzer. In the heat of the discussion, the question reverberating through the blogosphere was, “What was he thinking?” The easy answer of course, is: he wasn’t. Thinking, as in carefully weighing pros and cons, considering consequences, cost-benefits, and all that, nope, that probably wasn’t done, or at least, done thoroughly. It couldn’t have been a very cogent thought process that led him to pay $80,000 over the course of several years for dates (sessions? appointments?) with high priced prostitutes.

My inquiry here isn’t about sex or prostitution. It’s about risk and the private lives of public figures. What possible thought or non-thought processes allow the Eliot Spitzers, Mark Foleys and Bill Clintons of the world to risk their careers in such high stakes pursuits? Or, in some secret recess of their mind, do they want to get caught, to torpedo a career they don’t, albeit subliminally, want? In his Newsweek.com article, Notes on a scandal, Howard Fineman, writes:

Spitzer is a type I have seen before: a candidate who needs to rocket at warp speed because he does not dare stop to consider whether he really wants to be living the political career he is living. Spitzer, it turns out, hated some or all of what he was, what he wanted to be, or what he had become. Why else would he knowingly risk destroying his life’s career?

One wonders, how many people, at the top, or near to it, find themselves in a life no longer their own? Surrounded by people they don’t like or don’t trust, doing a job they don’t like, or responsible to a public they scorn? Is it much different from anyone of us stuck in a job or role we don’t like? We manage to tolerate it by engaging in things that take the edge off, some illicit, others less so: drinking, hanging with buddies, hobbies, having affairs or visiting prostitutes, etc.

But for a leader in a public position, it’s a different story. We imbue the role of leader with heroic stature, we don’t want to know about the private doubts, fallibilities, and lack of perfection. We don’t want to see ourselves up there, some poor schlub bumbling and stumbling, we want to see heroes.

It’s a love/hate relationship we have with the human side of leadership. On the one hand, we love a personable, folksy, emotionally accessible person, the “Gipper,” the fatherly or motherly figure we can relate to. Yet on the other hand, we demand strength, infallibility, and heroism. And we are surprised to discover our leaders have human desires and needs, just like the rest of us.

This pressure to be perfect we put on the role of leader creates a schism between the public self and the private self. The public self is the hero, the private self remains inaccessible, hidden from public view. And so a gulf begins to widen between the public role and the private self widens, eventually morphing into a compartmentalized existence, a split personality of sorts. Over time, even the leader starts to believe in his or her public self, believing that what’s performed on stage is the real self. Likewise, the private self, the needs, emotions, self-doubt, and desires that are kept out of the picture become so secret that it is easy to believe they don’t exist, that others can’t see them. Because I don’t see this part of myself, others can’t either. But our secrets compel us. Our hidden selves are most dangerous; they become autonomous and push us to do things, even reckless things, in order to be gratified and indulged.

This is a problem for public figures and for all of us in jobs where the role demands a one-sided expression of the personality. And positions of power and leadership are typical of this. In so-called normal life, the boundaries between parts of ourselves are probably meant to be thin, almost permeable. It’s messy this way, but robust and secure. It’s what we call conscience. My professional self is there to remind me when I am at the office party, hey, you have to be at work on Monday with these people, watch yourself. Or, my parental self is never too distant, even if I’m holiday, or out for dinner, the parental antenna is on alert, just in case the phone rings.

But in roles where the stress, expectations and demands are super high, the boundaries thicken, sometimes necessarily so. Walls go up to protect and buffer the one self from the others. Police officers or soldiers for instance, frequently report that they cannot share their experiences with their close friends and loved ones. They come home, sit in front of the TV, or drink, and numb themselves out. They do not, and cannot transition easily between public and private selves because the experiences they have in their public selves are beyond what most people want to hear about.

When power comes into play, the walls between public and private self are fortified by the trappings of the job itself – unlisted numbers, personal assistants, wood paneling and leather furniture, a limo and driver, private jets, mobile devices, and layers and layers of intermediaries that protect them from contact with their everyday self. There’s a scene in the romantic comedy, The American President, where the President wants to get flowers for his girlfriend. But for the life of him, he can’t get past those walls. He picks up the phone, but discovers he can only reach the White House switchboard. He doesn’t have a car he can drive himself. He can’t leave the White House without the Secret Service. Once, he finally manages to get an outside line, the florist shop assistant hangs up on him when he says. “I’m the President,” certain it’s a hoax.

But if we see leaders as heroes, we should remember that heroes and gods are meant, in the words of Whitman, to contain multitudes. Our superheroes all have alter-egos for whom we cheer just as loudly as for their amazing feats of strength. We love Peter Parker as much as we love Spiderman. It makes our superheroes even better, that there’s a flip side to them, that there is someone we can relate to, someone who fumbles in conversation, who wears glasses and pocket protectors and is picked on by the school bullies. Even the Greek gods reflected this paradox. They were venerated for their superhuman abilities and strengths, while at the same time driven by jealousy, vengeance, and insatiable appetites. They were saviors and villains, all without contradiction.

But in our modern version of heroes, in our leaders, we don’t tolerate that dualism. So leaders become estranged from their alter ego, from friends, family, and most of all from themselves. The walls that protect the private self from the public one create a loneliness that can’t be assuaged. We can’t be our self, our full self in public, with needs and desires. But in private, we indulge them. We cannot seek solace in public, where we will be shamed, but in private, with strangers, with people who are paid to listen, paid to care, paid to be nonpartisan. And as Charlie Sheen says, paid to leave afterwards.

In Primary Colors, Senator Jack Stanton, (a thinly disguised Bill Clinton) is sitting in a donut shop, at what seems to be 1 am. He’s the only customer, sitting in that cold florescent light of the shop. The camera pans out wide angle, and we see the empty streets, the loneliness of the city, of the hour, and of the man, as he in turn soothes and is soothed by the guy behind the counter. And you sense, this is what he’s craving, and perhaps what brought him to politics in the first place, the desire to connect with people, the ultimate bringing together of the real self and the public role.

I don’t believe leadership is best served by the parallels drawn to war and sports. It doesn’t capture the sense of service and eldership at the heart of leadership. But I do see one reason why military and sports metaphors are so often used to describe leadership challenges. War and sport have in common the need to develop mental toughness, so what you learn can be done under terrific psychological and physical stress. For an athlete, learning what to do is only part of the preparation; learning to do it on game day is another. That’s the difference between just being athletic, and being a top competitor. The professional athlete’s training includes psychological toughness by simulating game day conditions: high stakes, bad calls, mean crowds, horrible weather, and ruthless opponents. Because every athlete and coach knows that once you cross a threshold of stress, learning and thinking goes out the window. If you get triggered by stress, choking is inevitable. (more…)

Photos taken of U.S. Presidents before and after their terms in office show what a huge toll that job takes on the body. In the four years between inauguration day and the end of term, Presidents often look like they’ve aged 10, not just 4 years.

It’s a grueling job, with a lot of pressure. What we see on the outside is only the tip of the iceberg. Many of us, while not quite as high profile, are in leadership positions that put a terrible strain on mind and body. What happens to the body and mind under the weight of public pressure and tensions of leadership? What toll does public attack and humiliation take on the mind and emotions? What about our energy and drive, after plans and ambitions are torpedoed by opposition, sunk by the weight of inaction, or stalled by endless rounds of skeptical questioning? (more…)