Do traumatised leaders hurt their people?

This past week the World Psychiatric Association held its regional congress in Addis Ababa, Ethiopia. Mental health researchers and clinicians from all over the world joined their colleagues from Africa in sharing research findings and experiences in taking care of the mentally ill.

The Ethiopian government demonstrated its commitment to mental health at the meeting which was attended by the country’s first lady and high-ranking government officials. An initiative to reduce stigma and improve the quality of life of mentally ill Ethiopians was showcased, and we were impressed by the gradual increase in the number of Ethiopian psychiatrists over the past 10 years.

PSYCHOLOGICAL TRAUMA

At this meeting, I presented a paper on the impact of psychological trauma on our leaders’ performance. Over the past few years we have had the opportunity to study the life stories of many African leaders from independence to the present day.

A defining characteristic of independence leaders in most of our countries is the fact that many of them had survived significant trauma exposure on their way to their countries’ leadership.

Many had led wars against colonial authorities, while others had endured detention and torture before their countries got independence.

The subsequent leaders in many countries have included opposition leaders who have managed to dislodge vicious dictators.

DETENTION

These leaders have often been forged in the searing crucible of opposition politics in countries that had godlike leaders who would not hesitate to eliminate any sign of dissent

Detention, assassination attempts, torture and forced exile have been the lot of many opposition leaders who eventually succeed in winning their countries’ top posts

African leaders have therefore experienced potentially traumatic events as survivors, perpetrators, or witnesses of atrocities in a similar fashion as other citizens.

It is a well-known fact that exposure to traumatic events results in a variety of mental disorders in at least some of the survivors.

TRAUMATIC EVENT

While estimates vary across countries and depend on the type of traumatic event, studies have shown a relatively high prevalence of posttraumatic mental illnesses including posttraumatic stress disorder, mood disorders, anxiety disorders, and substance use disorders.

These conditions are often debilitating and change the way a person thinks, feels, and behaves. They change the quality decisions a person is likely to make.

While this is accepted for the general population, it is surprising that less is spoken about the same conditions among our leaders who have very publicly suffered traumatic events that cause trouble for most people.

Anecdotal evidence in the mental health community suggests that many of our leaders are suffering in silence, but the results of their suffering are very public and have far-reaching effects.

Atwoli is Associate Professor of Psychiatry and Dean, Moi University School of Medicine; [email protected]