As April Fools Day approaches, the title of this blog is not an April Fools joke. Really! Yet, if not, how can I be advocating negative leadership after writing the recent blog "Zen for psychiatric leadership," which portrayed and advocated the positive, cerebral strategy of the Zen master basketball coach, Phil Jackson?
Instead, the focus of this blog is another basketball coach, Bob (Bobby) Knight. Though just as successful as Jackson, albeit as a college coach, Knight was more of a negative, action-oriented, chair-throwing leader. He also has been aggressive and not too politically correct with his words. Recently, commenting on professional basketball teams drafting college players after they were in college just one year, he said: "It's as though they've raped college basketball." Afterwards, he defended himself by claiming: "The word rape can be used in several ways."
Like, Jackson, Knight also wrote an autobiographical book, Knight: My Story, published in 2002. Last year, with Bob Hammel, he wrote The Power of Negative Thinking.
Emphasizing negative thinking seems to go against the grain of the commonly spouted power of positive thinking. Even his wife, a former high school basketball coach herself, warned him against "being too negative."
Mr. Knight disagrees. He feels that his coaching principles can be generalized to leadership in business and other areas of life, presumably to include behavioral healthcare. As an example of these principles, he lists "always worry" as the third of his Ten Commandments of leadership. Especially worry about being overconfident, he warns. The ninth commandment is "never talk too much." Perhaps he broke his own commandment in his comment about rape!
Some of the leaders whom he feels succeeded through negative thinking are Washington, Lincoln, Eisenhower, Shakespeare, Leonardo da Vinci, and Pogo. He lists overconfident failures as Robert E. Lee, Napoleon, and Hitler.
What, then, of these principles could apply to psychiatry? "Always worry"? Doesn't that come from overly anxious patients who want that to decrease? "Never talk too much"? That's for the traditional psychoanalyst, not most of modern psychotherapists, is it not?
Could it be that the intent is psychologically paradoxical? As Knight says, the point is not to push people to do what they can't do, but to what they can do. Certainly this is good advice for both behavioral healthcare administrators and cllinicians. There is a problematic tendency to push people to do what they can't do in our field. Perhaps due, at least in part, to reimbursement concerns, role diffusion has spread. Most disciplines claim to be able to do psychotherapy, though often the cheapest, not the best, is preferred by payers. When should the prescribing of medication be limited to psychiatrists, rather than nurse practitioners, family doctors, and in some places, psychologists? Although the majority of psychiatric medications are prescribed by general doctors, the success rate leaves much to be desired. Within the profession of psychiatry itself, unless you are also trained in Child & Adolescent psychiatry, one should avoid prescribing to children. Whether you are running a sports team or a behavioral healthcare team, or participating in either, you need not only a clear appreciation of your strengths, but also your weaknesses.