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THE ROLE of psychiatric consultant1 to institutions and groups carries with it the unique advantage that comes to one who is privy to the confidential details of what goes on "inside" and who is at the same time a free agent whose professional or job destiny is not wrapped up in the institution itself. Under these conditions, certain behavioral patterns come into remarkably sharp focus. One of these, the effect upon the institution of placing a certain type of obsessional "Neurotic Character" in an administrative role is the subject of this report.
Most of the data are my own but, in a few instances, interested and generous colleagues have contributed case material from their files with the proviso that I keep the sources confidential. The nature of the material obviously requires this treatment and I have sought out these data because I had no other means available to fill in the gaps in my own information. I regret only that I cannot more publicly thank my colleagues for their generosity.
The subjects, twelve males, henceforth to be identified as Subject, all carried the degrees necessary to the practice of their professions—medicine, psychology, and social work. The majority were psychiatric residency trainees. Only one Subject is still practising in his specialty, all having had violent confrontations leading to their being "fired" or threatened and two having suicided under such stress. In the two suicidal