This paper focuses on the relationship between an administrator's personality, the organizational structure, the group processes within the organization, and the organizational tasks as observed in several psychiatric institutions. Basic assumptions in the personnel cause them to coalesce into different types of groups which are described. The patient pathology with which the staff deals can negatively influence both leadership and administrative structure. Primitive emotions latent in the personnel may erupt with antagonism to authority. Inevitable loneliness and loss of feedback from peers, the frustration of dependent needs, and the revival of early conflicts and fears threaten the leader in stressful situations. His primitive aggressive drives are activated by regression in the staff. The most paranoid member of the staff may emerge in opposition. Sadomasochistic relationships between a dominant male leadership and female staff often develop.