Does Vladimir Putin suffer from a mental illness which could explain the war against Ukraine or which could push him to use the nuclear bomb? All psychiatrists approach the issue with great caution and recall that it is impossible to make a “remote” diagnosis, without having carried out a medical interview beforehand. Some argue that cultural differences and language barriers make it difficult, while others fear that even asking the question will stigmatize their patients – when psychiatric terms are already misunderstood and misused in everyday language – or even that it disempowers Vladimir Putin’s behavior.
The psychiatrist and clinician Patrick Lemoine partly shares the caution of his colleagues, but he agrees to put forward hypotheses. He has already lent himself to the exercise in his book The mental health of those who made the world (Odile Jacob), in which he analyzed many historical documents relating to the great figures of our history. He also devotes a chapter to Vladimir Putin in his next book, The mental health of geniuses (Odile Jacob), where he will deal with geniuses of good, evil and those outside these two fields.
L’Express: Does Putin suffer from a mental illness? If we are to believe the Elysée, Hillary Clinton or a Russian journalist quoting relativeshe would suffer from paranoia.
Patrick Lemoine: I have three hypotheses. The first is that Vladimir Putin is a great patriot, perfectly normal, intelligent and wanting to make Russia great again. Opting for an imperialist and expansionist policy aimed at enlarging one’s territory is not a psychiatric pathology. And this is a hypothesis that seems to me very solid.
The second is that he is very paranoid. He also repeats constantly: ‘You are threatening me, the presence of NATO on my borders means that you want to invade and massacre us’, but I’m not sure that’s just rhetoric. And while all great paranoiacs show remarkable logic, there is always a flaw. Putin’s is that he sends his army to Ukraine, then threatens to use the nuclear bomb there, while his troops will suffer the consequences. I also wonder if he does not believe his lies – particularly when he asserts that the Ukrainians are using their population as a human shield against bombardments, then assures that he is not bombing civilians – because the ability to believe one’s own lies is typical of paranoids. If we add to that his coldness, the inexpressiveness of his face, his lack of humor, and his megalomania, the hypothesis seems solid.
My final guess is based on the recent swelling in her face. It could be Botox or a cosmetic operation gone wrong, but given his means, that would be amazing. Otherwise, the use of cortisone could explain them. This drug, prescribed in cases of serious illness such as cancer or multiple sclerosis, is known to lift inhibition, promote megalomania and impulsivity. The hypothesis is daring, but holds water.
What predictions do you make based on these assumptions?
None are reassuring. The first two are even very disturbing. Whether he is patriotic or paranoid, he will follow through with his idea. The cortisone hypothesis could be the most reassuring, because it is possible to stop this treatment… Unless he suffers from a chronic illness.
You agree to put forward hypotheses when some of your colleagues consider this to be impossible, even risky. Why ?
In my book The mental health of those who made the world, I offer a diagnosis of King Solomon. However, I never saw him and did not talk to him. But by analyzing historical documents, portraits of him, it appears that he was most likely bipolar. And today we also have videos and audio.
I did not examine Putin and I did not ask him questions, so I cannot make a diagnosis, but I observed him, I heard him, and that allows me to put forward hypotheses. For example, when I see the hallucinating fixity of his face, I think of Parkinson’s disease – an unlikely hypothesis – or depression. But it could also be explained by paranoia or cortisone. A friend of mine had dinner with Vladimir Putin – before his face was so swollen – and had already told me of his discomfort with that chilling stare, the expressionlessness of his face and the fact that he gave the feeling convinced that he is right. So many details that further support the paranoia hypothesis.
ALEXEY PANOV / POOL / AFP
And then we must remember that diagnosis in medicine is above all intuitive. This has been shown in numerous studies that doctors – and especially psychiatrists – usually make their diagnosis four minutes after the patient enters their office. This does not necessarily mean that we will directly formalize our diagnosis, but we will quickly get an idea, then we will ask questions to determine if our intuition is correct.
Could the cultural differences between France and Russia distort your judgement? Even if it means caricaturing, isn’t it logical that the Latins are surprised by the behavioral differences of the Slavs?
In his time, the famous psychiatrist Emil Kraepelin (1856-1926) observed that the difference in language or culture between the patient and the doctor did not change his diagnosis. I made the same observation when I visited hospitals and saw patients with psychiatric illnesses in China, Japan, Indonesia and the United States (I spoke neither English nor Chinese). At the end of the visits, I made my diagnosis and compared it with that of the local doctors: I was rarely wrong. Psychoses transcend culture: a bipolar in France remains bipolar in China, a paranoid in the United States remains a paranoid in Russia.
As for the stereotype that the Slavs are cold, it is wrong. Admittedly, they express themselves less with their hands than the Latins, but they are very expressive, they do not hide their emotions during great joy or sadness, for example.
Isn’t there a risk in medicalizing the speeches and actions of politicians? Isn’t there a risk of disempowering Vladimir Putin or leaders making bad decisions?
There is indeed a risk for you and for me if the Russians invade France, because we will quickly find ourselves in a Gulag! More seriously, when a head of state says that Putin is crazy, it is an invective that does not relieve him of his responsibility in the least. And when it comes to a psychiatrist like me, one could indeed fear it, but I’m not sure it weighs much. And I especially think that Vladimir Putin has absolutely nothing to do with it.
In the hypothesis of paranoia, what treatment would be appropriate?
In addition to treatment by a psychiatrist, it should already be ensured that Vladimir Putin maintains contact with his relatives, or at least that he is not cut off from the rest of the world. Emmanuel Macron keeps him on the phone for two hours almost every day, it’s absurd in such a period of crisis, but it could perhaps help to improve the situation.