Exploring leadership styles... and pondering which is needed most in psychiatry.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
Most leaders seem to develop a style of leadership, which comes from their personality and life circumstances. Here are some of the most common leadership styles.
Common throughout history is the authoritarian leadership style. Here, the leader dictates policies and procedures with limited influence by subordinates. Countries with this style of leadership are commonly called dictatorships. In psychiatry and medicine, we experience this style of leadership in the for-profit managed care control of health care systems, in which profits are prioritized over patient needs.
Politically, as democratic organizations evolved, an opposite style, sometimes called distributed leadership, emerged. In this style, leadership is spread around. Taking that even further would be servant leadership, in which the leader puts stewardship of resources first and accepts the risks to themselves as part of that. This style is illustrated by Reverend Martin Luther King Jr and Gandhi, both of whom were assassinated.
In psychiatry, Robert Jay Lifton, MD, seemed to illustrate that servant style in his research of humanity’s potential for destruction. Given the vulnerability of receiving secondary trauma, interviewing Nazi doctors as a Jewish psychiatrist required personal psychological courage; he also was willing to be jailed for protesting the Vietnam war.
Occasionally, an organization will have co-leaders, such as I had with a social worker in administering an award-winning community mental health center in Houston. But most commonly, consensus leadership is crucial in co-parenting of children.
Then there are situations in which major change in an organization seems required. Change leadership requires the ability to adapt quickly to a changing world. To accomplish that, transformation leadership may also be required, which involves a visionary leader who can inspire and elevate followers.
In the history of the field of psychiatry, we have not had the momentous changes that have occurred in some countries. However, some anti-psychiatry groups are advocating for such change in psychiatry, particularly in our use—or overuse—of medication.
Henry Kissinger, who advised several presidents, stresses in his new book on leadership:
Leadership is most essential during periods of transition, when values and institutions are losing their relevance, and the outcomes of a worthy future are in controversy.
He suggests that our country may be in that sort of crisis right now. Crisis can be a danger or an opportunity. What path will we take, and can we in psychiatry help?
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. To create a better world, he is an advocate for treating mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism. He serves on the Editorial Board of Psychiatric Times™.