The development of autocratic leaders in history reveals that many share severe character disorders that are consistently similar across borders and cultures. Diplomats and humanitarians negotiating for access to populations in-need and security of their programs, especially in health, must understand the limitations placed on the traditional negotiation process. These shared character traits stem from a cognitive and emotional developmental arrest in both childhood and adolescence resulting in fixed, life-long, concrete thinking patterns. They fail to attain the last stage of mental and emotional development, that of abstract thinking, which is necessary for critical reasoning that allows one to consider the broader significance of ideas and information rather than depend on concrete details and impulses alone. These autocratic leaders have limited capacity for empathy, love, guilt, or anxiety that become developmentally permanent and guide everyday decision making. Character or personality traits that perpetuate the lives of autocratic leaders are further distinguished by sociopathic and narcissistic behaviors that self-serve to cover their constant fear of insecurity and the insatiable need for power. Human rights, humanitarian care, and population-based health security are examples of what has consistently been sacrificed under autocratic rule. Today, with the worst global loss of democratic leadership ever seen since WWII, leaders with these character traits now rule in major countries of the world. While history teaches us of battles and conflicts that result from such flawed leadership, it lacks explanations of why autocratic behaviors consistently emerge and dominate many societies. Building multidisciplinary capacity and capability in societies among democracies to limit or cease such authoritarian dominance first begins with a developmental understanding of why autocrats exist and persist in externalizing their pathological behaviors on unsuspecting and vulnerable populations, and the limitations they place on negotiations.

“…once in power, a leader with an Antisocial Personality Disorder thrives on continuing conflict and never seeks peace.” Daedalus Trust, London, 2016

BurkleFMJr.Character Disorders among Autocratic World Leaders and the Impact on Health Security, Human Rights, and Humanitarian Care. Prehosp Disaster Med. 2019;34(1):2–7.