Idea in Brief

The Problem

Executives sometimes suffer from serious personality disorders, such as pathological narcissism, manic-depression, passive-aggressiveness, and emotional disconnection. When these leaders reach positions of power, they create dysfunctional organizations in which everyone is miserable.

The Remedies

An executive coach can help people combat these syndromes, provided the coach recognizes their signs and understands how to address them. Each pathology requires a different approach. Narcissists have fragile self-esteem (despite their apparent confidence) and react poorly to confrontation. Coaches must build them up carefully. In contrast, making manic-depressives face reality (in combination with therapy and medication) is key to getting them on track. The goal with passive-aggressives is teaching them to express anger in a healthy, direct manner. And exploring and describing emotional experiences helps the disconnected relate better to others.

The Bottom Line

Though some people will prove impossible to change, these disorders can all be managed, and with the right interventions, executives with them can turn things around and become effective leaders.

Senior executives have the power to create an environment that allows people to grow and give their best—or a toxic workplace where everyone is unhappy. How executives end up using that power depends in part on their mental health. Sound, stable bosses generally build companies where the rules make sense to employees, freeing them to focus on performing their jobs well. But if the boss’s psychological makeup is warped, business plans, ideas, interactions, and even the systems and structure of the organization itself will reflect his or her pathologies.

A version of this article appeared in the April 2014 issue of Harvard Business Review.