Wednesday, November 10, 2004

Leadership by Pathology

Pt ID: Fearless Leader
Age: 50+
SS#: Unknown (Privatized Account)

Referred by: Thinking Public

Reason for Referral to Mental Health: Follow up to mental health screening conducted on all elected persons as part of Post 9/11 Threat Management Protocol

Presenting Problems:

Per self-report Fearless describes a marked reduction of symptoms of anxiety, suspiciouness, dread, and concerns for job loss following re-election to a leadership post at the federal level on November 2, 2004. This is a sharp contrast to concerns expressed by Thinking Public over the past 4 years where there is described a series of Attitudes, Beliefs and Behaviors that pose and account for imminent harm to others by reason of disturbed mental functioning. Note is made that there is risk of a group delusional system of epidemic proportions in support of Fearless Leader's grandiose confabulations of achievement and success. These are made in the face of disintegration and failure on the parts of several large projects implemented and directed by Fearless Leader which are financed by the John Q. Public Corporation. Some of these projects are based overseas and have required the export of military and support personnel who are loyally following project protocols as defined by Fearless Leader and his closest cohorts who share his thought distortions. There have been increasing injuries and deaths among employees due to lack of appropriate safety standards, poor project design and poor management structure and support. Shareholders in John Q. Public are voicing concerns about costs and losses. Cohorts are displaying some unease intermittently as repeated failures in project goal achievements and evident misinformation reaches Public Scrutiny. There have been recent resignations from top posts supporting Fearless Leader's position. These collaterals are unavailable for comment or interview.

Fearless remains cognitively and emotionally oblivious to any concerns despite these factual reports. His defense system is intact and makes use of rationalization, minimization, denial and magical thinking to cope with the incongruities between historic events and his perception of them. His mood is grandiose, expansive, and playful. Thinking is simplistic but very rigid. He is visibly shaken when faced with questions or problems that cannot be responded to with his arsenal of one liners that he describes as his principles and message to the world. Speech is clear when he is repeating well known lines, but he displays malapropisms, mispronunciations, and stoppage of expressed speech when challenged to develop a new thought or means of communicating. He is oriented to person, but displays confusion as to place and time as he keeps drifting into a fantasy world representing the Dark Ages and the Crusades. While he disavows support of the actions of the Inquisition, he displays a grin over the advantages of Inquisition tools in gleaning confessions of lack of faith from that era. He can be prompted back to the present, but tends to drift into a young adolescent type inner world of planes, GI Joes, and cowboy life.

Family background is wealthy and influential. Fearless grew up with many advantages and with promises that he would always be protected from evildoers and harm. On 9-11 when there was an attack against John Q. Public's Corporate offices, lands and family, Fearless came to a standstill for several minutes, mechanically reading a story to some children when his immediate response was needed for crisis leadership and response. He was clearly unprepared for the reality of combined cunning and rage.

Behind Fearless Leader's confident air, grandiose statements, and bravado, there is an undercurrent and expression of anxiety and uncertainty. Observed sitting alone in the waiting room, Fearless seemed child-like and anxious, revealing a vulnerable aspect that is the likely core of his protective mantle. This core is fragile, and without a substantive healthy ego and identity. He adopts personae to best suit and protect his vulnerabilities.

Clinical Impression:

Fearless Leader is, as are many in the world today, suffering from loss of intellect; thereby displaying reliance upon simplification and denial of real problems, rigid attachment to a well rehearsed mantra of specious import, and volatile behaviors and need for control which have imperiled and resulted in the deaths of over a thousand employees. His behaviors and lack of insight and judgment have also imperiled the environment for the predictable future of 20-50 years, possibly longer. His barriers to communication and use of intellect have resulted in alienation from the global communities and marginalization of his largest corporation. He relies on millions of supporters who share his simplistic views to meet their own emotional discomforts. The lack of insight and judgment has caused direct harm to others. Consequently, I recommend he be removed from a position where he can use a child-like mentality to cause physical harm or peril to others or the environment. Such removal will result in rapid emergence of chaotic behaviors by supporters who will need time to learn to think individually and to develop insight and judgment beyond a reactive fear base. Time is of critical importance to protect the well being of others and to allow Fearless to learn new strategies and life style behaviors to cope with stress and anxiety. Family sessions would be of benefit with clinical team support.

Treatment modality of reality therapy would be most efficacious, requiring Fearless to live and work in a setting where he must support himself and his wife on $7-10 per hour, pay for housing, utilities, transportation, food, and medical expenses without access to his personal assets for a period of at least 1 year.

Respectfully submitted to the Thinking Public,
11-10-04

Wooden Shoe





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