The questions about the Vladimir Putin’s mental health is nothing new. But since his declaration of war against Ukraine, many observers no longer hesitate to attribute various mental illnesses or personality disorders to him. He holds speeches “accusatory, but also rigid and paranoid”, believe, for example, advisers to the Elysée. Hillary Clinton accuses him more directly of suffering from “paranoia”, when Czech President Milos Zeman, usually reserved towards the master of the Kremlin, no longer hesitates to call him a “madman”.
But can we really accuse the Russian president of suffering from a mental illness? And is it possible to make a “remote” diagnosis? According to “goldwater rule“, adopted in 1973 by the Association of American Psychiatrists, this would even be contrary to medical ethics. But in the absence of mental illness, do the actions and words of Vladimir Putin make it possible to identify personality traits? Answer with psychiatrist Antoine Pelissolo, university professor and head of department at the CHU Henri Mondor in Créteil.
The Express:Can we call Vladimir Putin or any other public figure “paranoid” simply by listening to him or watching him?
Antoine Pelissolo: The terms “madness”, “crazy” or “paranoid” are in common parlance. So common that many behaviors are called “crazy”, even when they are adopted by perfectly normal people. On the other hand, we do not use them in medicine. We psychiatrists diagnose mental illnesses. They are generally complex to analyze, except when the behaviors are extremely marked and obvious. They ask to spend time with patients – a psychiatric interview lasts from thirty to sixty minutes – and, in general, arise not after identifying a single sign, but a set of symptoms. And before considering that a behavior is abnormal, it is still necessary to determine if it has deleterious consequences, for the person or for others, for example if the person organizes his professional activity according to mistrust or fear. others. In short, it is clearly impossible to make a diagnosis until we have spent time with the person. If it were enough to watch a video, it would be so simple!
And it should probably be specified that in psychiatry, we are making fewer and fewer diagnoses by category. There are of course “high psychopaths” or “high paranoids”, but more often than not it is a mixture of different traits, such as people with mild paranoid and psychopathic tendencies. And within these categories, there is also great diversity. There are, for example, psychopaths who are smart enough to tone down their personality disorder and who do well in life. We often give the example of Bernard Tapie, who showed real transgressive behavior specific to psychopathy, which did not prevent him from succeeding in certain areas.
What are the symptoms that reveal paranoia?
If we take the common language term “paranoid”, two diagnoses come close to it. First there is the paranoid personality, then the illness that we call “paranoid delirium”. Paranoid personality is a personality disorder that affects a person’s life for a long time. This translates into a psychorigidity and a distrustful nature towards others – without necessarily being convinced that everyone wants us harm -, a way of interpreting words or facts as being signs of persecution, the desire to control others and the fact of having megalomaniacal tendencies: a grandiose vision of oneself and the certainty of being above others.
Paranoid delirium results in more marked features, a constant worsening of symptoms, and also delusional convictions. The person who has it may, for example, be convinced that he can save the world, or feel so superior to others that he imagines that everyone is jealous of him, that everyone wants to take his place, even that they want to kill her. The risk with these people is that they can totally lose touch with reality. Some become so unlivable that loved ones end up rejecting them. Others barricade themselves at home and cut themselves off from the world in order to stay in their bubble. This is what we call the breakout zone. There is then a risk of non-rational impulse. When this phenomenon is very marked, it can lead to malevolent actions, such as the desire to take revenge, to attack or even kill the enemies supposedly “to defend themselves”.
But it must be emphasized that the behaviors resulting from paranoid delusions are not “completely crazy”, in the sense that there is an internal logic to paranoid delusions that we can understand, unlike schizophrenia, for example.
“The Russian president shows a megalomaniacal tendency that we find elsewhere in very many leaders”
Do Vladimir Putin’s aggressive behaviors and speeches not reveal certain traits associated with these two diagnoses?
The Russian President shows a a megalomaniacal tendency that we find elsewhere in very many leaders: politicians, business leaders and heads of state, especially the most authoritarian. It results in a very great self-confidence, a grandiose vision of oneself or at least a very high idea of its value, the will to change the world. All this is not necessarily negative. But in Vladimir Putin, there is also this desire to crush others, as well as a pronounced narcissism. This reveals a real megalomania. We can therefore, at least, say that he has a megalomaniacal personality.
This trait could suggest a paranoid personality, especially since it manifests other aspects, including mistrust of others, allies or enemies. But we don’t know, for example, if he tends to interpret other people’s intentions as malicious. The diagnosis is therefore impossible to make, just like that relating to paranoid delusions. We should question him beforehand, and therefore spend time with him, try to understand why he is acting this way. Not to mention that we could also consider that his statements fit into a communication strategy, a staging aimed, precisely, to make people believe that he is paranoid, to scare.
“It is impossible to say that Vladimir Putin is a psychopath”
Does he have traits linked to other mental illnesses?
One could find in him a certain psychopathic dimension. It results in the non-recognition of the rules – the Russian president violated international laws with this declaration of war -, but also in the lack of empathy, because this war will cause many deaths. But one could also object to this that he was raised by the army, that he was cradled from a very young age in an environment made up of strict rules that he knew how to respect. It remains impossible to affirm that Vladimir Putin is a psychopath. What is certain is that he is aggressive and does not seem to have many limits when it comes to attacking the integrity of others.
Dementias, such as those caused by Alzheimer’s disease, can also lead to behavior that is totally disorganized and incompatible with the functions of head of state. This can manifest itself, at the beginning, by delusions, then loss of memory and language. But as far as Vladimir Putin is concerned, that seems out of the question.
“Putin excels in the art of manipulation: he wants and knows how to scare everyone”
Isn’t starting a war of aggression necessarily a sign of mental illness?
Personality disorders – such as paranoid personality – induce some degree of impaired judgment that can lead to irrational acts, such as starting a war. But this does not necessarily indicate actual paranoid delirium. And then there are people who are simply evil and malicious, or at least, to stay in the register of psychiatry, who have an absence of empathy.
Mixed with the rest, this can explain the aggressiveness towards others, or the desire to start a war to establish one’s power and greatness. If we take into account that this decision will lead to the death of many people, it is possible to associate it with psychopathy, perversion. Human psychology is complex: many factors and causes can explain why a person harms others.
Behind the questions about Vladimir Putin’s mental health hides the fear that he will decide to use the atomic bomb. He has also threatened NATO and its allies on several occasions in recent days. Do you have to be crazy to use such a weapon?
Going all the way – “pressing the red button” – would be irrational – because suicidal – behavior for a head of state. This could be related to a loss of contact with reality and therefore to delirium. But here again, it is impossible to judge Vladimir Putin’s motivation, especially since he excels in the art of manipulation: he wants and knows how to scare everyone. His strategy could therefore not be delusional, but very rational. And then we must not forget that the heads of state are part of an apparatus, a system that can exercise control over them if necessary, even in Russia. Firewalls exist. At least I hope so.