When world leaders speak publicly, as many will do at the U.N. General Assembly, the CIA will be poring over not only what they say, but how they say it. Intelligence agencies devote considerable resources to ferreting out not only the physical well-being of presidents and prime ministers but their mental health as well. The two are closely linked, but mental health is more difficult to determine from afar. First part of our story:
Films and books abound with fictional stories of a leader gone mad who does something totally irrational, like starting a unprovoked war or launching a nuclear attack. But the possibilities of fiction becoming truth are real, especially in a country where one person holds absolute power.
Special CIA Unit
The concerns are strong enough that the CIA maintains a special unit to look for clues as to the mental stability, as well as the physical health, of world leaders. Dr. Jonathan Clemente, a physician who is researching a book about medical intelligence, says the goal of the CIA’s Medical and Psychological Assessment Cell, MPAC, is to determine how a leader will act.
“What they try to do on the psychological side of things is describe a constellation of psychiatric signs and symptoms, and to describe for the policymakers how someone with that particular set of findings may react to certain situations,” Clemente said.
The effort to analyze the mental state of foreign leaders goes back to the CIA’s forerunner, the Office of Strategic Services, the OSS, which did a psychological profile of Nazi Germany’s dictator, Adolf Hitler. Dr. Clemente says the CIA, which came into being in 1947, formed a small unit called “Leadership at a Distance” to continue the profiling.
“In the late ‘50s and early 1960s, CIA decided that they had expertise to look more carefully and in a more rigorous analytical way at the health of foreign leaders in order to help give policymakers some forewarning of the transition in a government, stability of foreign governments, and also looking for potential points of diplomatic leverage,” Clemente said.
Psychologial Profiles Used in 1978 Camp David Peace Taks
Dr. Jerrold Post, a clinical psychiatrist and political psychologist, put together the CIA’s major systematic effort to analyze the physical and mental state of world leaders. He says the turning point for the effort was the psychological profiles he did for President Jimmy Carter for the 1978 secret peace talks at Camp David with then-Egyptian President Anwar Sadat and Israeli Prime Minister Menachem Begin. Dr. Post says the three profiles drawn up - one each of Begin and Sadat, and a third on how they might interact - were of enormous help in reaching the eventual Camp David Peace Accords.
“The third was quite interesting. It had a terrible title in retrospect - something like “Contrasting Cognitive Styles of Menachem Begin and Anwar Sadat, Problems and Implications for Simultaneous Negotiations” - in which we described that in the way their minds were built, even if they totally agreed they would be talking past each other, and the importance of the president in playing an intermediary role,” Post said.
Impact of Terminal Illness
Analysts say the physical and mental states are deeply intertwined. A terminal illness, they say, can push a leader like Venezuela’s Hugo Chavez into impulsive decisions in order to preserve their legacy. Dr. Post points out that Menachem Begin made two critical decisions - the pronouncement of Jerusalem as the eternal capital of Israel, and the application of Israeli law to the captured Golan Heights - from a hospital bed.
“These two issues are two of the central issues now in the Middle East crisis and stumbling blocks in the negotiations. And my way of seeing it is that it was the imminence of death which led him to make these extreme actions,” Post said.
But determining a mental condition from afar is a difficult job because the symptoms are often far less visible, says Dr. Rose McDermott, a political psychologist at Brown University who has written extensively on medical intelligence.
“Illnesses themselves tend to be less exact. So you can imagine an illness like bipolar disease that can range from pretty minor, well-controlled on medication, to pretty extreme and not well-controlled on medication. I know I’ve heard various rumors going around that there’s concern that [Afghan President Hamid] Karzai has some medical psychiatric illness. And it’s very hard from a distance to say, well, is that a psychological illness or is it substance abuse or to actually differentiate what kinds of things are going on,” McDermott said.
She adds that a leader’s behavior may also be affected by medication taken for a physical condition.
“The concern isn’t just the illness, it’s also the medication people take while they’re ill and how that can compromise their decision-making ability, cognitively and intellectually, so they don’t make the same kinds of decisions. Their decisions may not be as predictable. They certainly may not be as, quote, unquote, rational,” McDermott said.
And irrational behavior by a president, prime minister, monarch, or despot can have repercussions that can ripple throughout the world.