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111El B IAbs~ract] The present study examines psychological characteristics of

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.;"."" ". 11 Im Ge~rgian President Mikhail Saakashvili, concludes trom the analysis of
available data that he has certain psychiatric disturbances and makes
r)\ 11 11 a diagnosis. The study offers also practical advicewhich should be followed
whi le dealingwith PresidentSa.akashvili. In view of its sensitivity the study is
. fj.m for limited distribution only.
We wish to acknowledge the contribution to the study made by:
m r ID Tonsherg Psychiatric. Centre, Orsnessale, Norway;
m Nat!cnal Tnstituteof Public Health, Oslo, Norway;
Department of Psychiatry, Kuopio University Hospital, Finland;
"I!i D ia Ce.ntre for Nervous Deceases, Christian Atbrecht University, Kiel, Germany;
tI Dcp!!rt~en{ of Psychiatry, University of Geneva, Switzerland;
Department of Psychoanalysis and Psychotherapy,
-"" University of Vienna Medical School, Austria;
Department of Clinical Psychology, University of Amsterdam, Netherlands.

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1. Anamnesis and family history
Information about Saakashvili's childhood and adolescence is insufficient. Raised in a
single-parentfamilyenvironmenthe grew much attached to his mother. Early in his life due to a
deep emotional trauma he became very negative and aggressive towards his biological father.
His relationship with his stepfather later in his life was also tense and bitter. He also had
difficultiesin undemanding and e~tablishingrelationswith other people of his age and was often
treated as an outcast and a "loner". This situation was partially corrected and his social skills
improved when in high school he joined a school theatre group and took part in some of its
theatricalproductions.

At the same time, together with some other classmates, he became actively involved in an amateur
film production, including pomo films. When this incident finally became public and a scandal
broke at school he had to leave his homctown and went to Kiev. During the following period he
immersedhimselfinto a lifestyleof destructivebehaviour,parties and sex. His apartment at
that time was often offered to his fetIow students and friends as a place for intimate
encounters and he used this as a way to gain popularity and establish his place in the "in crowd".
By the end of his freshman year he got involved in yet another confrontation with the
establishment and was expelled from Komsomol organization. In order to calm things down
he volunteered in the Anny and spent two years in service.

2. Behavioural pattern~
The overall partem of SaakashvjJj's social behaviour is defined by persistent conflict
existing.between this exteriorized behaviour a.ndhis internal emotional component. While
demonstrating and often exaggerating his sincerity, expressiveness and communication skills
on the outside,he presents all the signs of internal tension,nervousness,suspicion and emotional
vulnerability.The nonverbal component of his behaviour is especially representative and
informative in this respect. While his facial expression is usually lively and matches the
behavioural context, his gesticulation (his hand movements tend to be uchopping-like" with
palms being constantly spastic and this "closed-inUpattern doem!t change during the whole
period of verbal communication, even when the communication environment is in its most
positive and favourablephase),
I
body posture and rigidbody languageare all out of context
~

On the scale of motivational factors his fOOitionon pride and self-esteem and his egocentrism
prevail over altruistic tendencies and public interests that he pretends to demonstrate in public.
This detemUnes his inability to adequately control his internal outbursts of resentment when he
feels that he is not being appreciated enough. These outbursts may happen even when he
consciously and sincereJy intends to express his loyalty and readiness to cooperate with the
counterpart. Saakashvi1i has demonstrated th.8t he finds it difficult to organize his thoughts and
express himself when he is being coniTonted with unexpected, compHcated and personally
unpleasant issues. Though in general be has a fairly good level of verbal skills, under the above
circumstances he tends to get confused and resorts to obviously meaningless, lengthy and
empty wording in order to avoid a clear-defined and down to business answer and thus intends
to oVeIWhelmhis counterpart. A situation when during one of his public appearances he was
askedabout his income can be a good illustrationof such a pattern of behaviour.

Extreme egocentricity of Saakashvili's personality often becomes an obstacle for himself when
a situation is cal1ing for a fresh and original ideas and spontMieousreactions. He intuitively
recognizesthis constraintand tries to mask his egocentrism by acting out in a verbose and
extremely eloquent manner, expecting to produce a "spell- like", mesmerizing effect on his
opponents.

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Saakashvili's behaviour consistently demonstrates that his emotionaJ response and his abiJity
to express signs of excitement and genuine interest primarily occur when his persona., his
exceptionalityan-dsignificancebecome the centretopic of the discussion. He looked exited and
radiant,if not happy. when he Wasonce posing in front of hjs car, showing bullet holes in the
windshield.To him the fact that he was a "target"of an assassinationattempthad put him in line
with other world leaders and dignitaries. His exaggerated, theatricaJ and openly deliberate
personal style nevertheless lacks spontaneity, easiness and showmanship, so typica1for
other hysteroid types.

3. Psychologicalaspect
3.1. Intellectual component IQ level is above average with active type of reasoning, good
levelof abstract and analytical capabilitiesand ideation. Subject's ideation activity on one
hand combines impulsiveness,tendencyto followemotional logic and initial internal impulse
and on the other hand above average ideationrigiditywith tendency to constantly conceptualize,
create static, emotionally saturated ideas and groups of ideas, capable of asserting the
importanceand exclusivity of his own personality.Due to the extreme rigidity of these ideas
Saakashviliis open onJyto the informationthat agreeswith his conceptual structure and he totally
excludesthe rest that exists outside this scope.Taken to the extreme, this tendency may beCQme
transformedinto megalomania, obsessive or maniacal syndrome characterized by a personal
convictionof being destinedto be the "chosenone",

Thoughhis general education level is above average and his ability to form channels of verbal
communicationis sv.,ift,smooth and even with a hint of artistry, his reasoning Jacks depth,
originalityand independence. Pretending to be special, creative and exclusive his reasoning
nevertheless is rather ordinary, predictable and often based on common knowJedge and
plagiarism.Finding himseJf in an unexpected situation or being confronted with unanticipated
questionshe finds it difficu]t to come up with the right answer and in order to save his face he
becomesverbose,sidetracksand eventuallyswitchesto othertopics.

3.2. Motivational component. Subject's general level of activity is noticeably elevated.

Primary motivational factors include ambition, vanity, superiority, extreme competitiveness
and dominance. We may assume that Saakashvi1i's low self-esteem and compJex of
inferiority, both formGdearly in the childhoodbut suppressedat present, have determinedhis
stTOngurge for power. These dominant internal factors have transformed through hyper
compensatorymechanism of defence into partialand at times complete loss of sense of reality,
adequatebehaviouralresponseand capacityto perceivecontextualreality.

His overwhelming egocentric desire for se1f-affirmationand strong conviction in personal

superiorityput him into a position when his politicalcareer becomes only an instrument in his
questto gain socia1rccognition that he has been denied for so long. He is so overwhelmed with
this interna]passion for proving himself at all times that he is not capable to accept the civic
valuesof the society that once rejecte-dhim. We may only expect that this win lead him into
moreconflictswithtilissocietyin the future.It is importantto recognizethat in his pursuitfor
power he may easily loose the sense of danger and natural fear of consequences of his own
decisions and this makes him capable of provokingserious conflicts, including political and
military.

33. Emotional component Emotionalexcitationlevelis above average.His personality tends to

present stab1esigns of hyperactivity, elevated 1evelsof emotional status, excessive self-
esteem and extremely high ex-pectations.He is very active, vigorous and resourceful in
achievinghis persona}goals. At thesametime,beingextremelyself-centred,he can be easily
heart, tends to hold a grudge and be very emotional about it, even to the point of seeking

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revenge. His exterior emotional manifestations are expressive, intense and at time theatrical.
He easily develops internal tension and becomes defensive, negative and jealous towards people,
who herecOgni7..eSas surt-'assinghim in something.

4. Diagnosis
Expansive type of paranoid dysfunction (according to ICD-IO) combined with narcissist type of
hysteroid personal1ty.

Paranoid aspect is translated into excessive intellectual and emotional rigidity, tendency to
"getting stuck" and form fixations on certain ideas and concepts. In case of Saakashvili this
may have been caused by extremely high emotional status of his past experiences carrying a
specialsignificancefor him.

Saakashvili's personality is characterized by typical for paranoid types excessive self-esteem,

hypertrophied sense of pride combined with excessive sensitivity towards failure and negative
social response. He attaches special importance to everything that is related to his own
personalityand his personal interests.At the same time anything existing outside this "personal
circle" becomes exc1uded fTom the domain of his active attention. Saakashvi1i presents
persistent tendency to put himself in opposition with the rest of the society and perceive the
world around him as a hostile environment.As an obvious responsehe expresses this perception
in a form of extreme vigilance and distrust towards others.

He is incapable to act based on idealistic motives and rejects this ability in others. He is prone to
suspect others of being unfair, insolent:, and envious, with intentions to humiliate, insult, entrap
and dishonour him. Above described personality disorders could be observed in Saakashvili
since very early in rus adolescence and throughout his adult life.

Saakashvili's tendency to create super ideas is especially typical for paranoid dysfunctions.
Super ideas totally enslave the entire personality and completely determine its behavioural
patterns. One of such super ideas thatkeep Saakashviliobsessedat the moment is his pursuit for
powerand self-promotion.,-

A distinctive feature of Saakashvili as of an expansive paranoid type is his vigour, dynamism,

at times even restlessness and disregard for rest andfatigue.

Saakashvili'snarcissism combined with hysteroid traits determines his pathological ambition,

aITogance,sense of superiority and exuberantly high opinion about himself. He is irrefutably
convinced in his own righteousnessand personal importance,is intolerant towards any fonn of
criticism and tends to exaggerate his personal accomplishments.His ability to work effectively
goesalongsidewith desirefor public attentionand admiration. His decision to choose politics as
a profession was a very natural choice for him, since he wouldn't have got himself involved in
anyotherfieldthathadn'thadpromisedhima speedygratificationin a fonn affame andpublic
recognition.As most of narcissists he lacks empathy, is indifferenttowards other people's needs
and feelingsand "perceivesthe rest of humanityas facelessapplaudingcrowd".

5. Recommendations
Taking into consideration the combination of paranoid dysfunction with hysteroid
symptoms that dd'im: Saakashviii as a person, we offer the following recommendations with the
purpose of creating an atmosphereof personaltrust and opennesswhich may open a window of
opportunityfor loweringhis self-controland predisposehim to act in an open and sinceremaIIDer:

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 It is advisable that the counterpart (interlocutor) should demonstrate an obviously
positive intention in a foml of expressing sincere interest in Saakashvili's
personaJityand demonstratingappreciationand "proper"recognition.
Contrast approach: initial phase should include a demonstration of interest in
everything concerning Saakashvili's personality, his merits, praise his real and
nonexistent accompJishments and then introduce a comment putting this
statement under a shroud of doubt. We expect that under the circumstances
Saakashvili may try to substantiate his "reputation" and talk more than it was
initially intended. .
Tt is possible to motivate Saakashvili t.o repeat his discourse about a situation of
certain importance and demonstrate a degree of scepticism. Under this sort of
pressure. hysteroid types terydto exaggeratethe fictionalcomponent and add new details
in order to make it al1 look more credible. Often these additional details are
contradictory and thus add new semantic shades to the whole narration about the
same account. This may open an additional ground to add questions, single out
contradictions and request clarifications.
It is very probable that Saakashvili has low tolerance towards infonnation deprivation,
anticipation, inactivity and loss of interest towards himself. Being forced to operate in
such a context he may initiate a communicationprocess, may develop a desire to "speak
himself out" and attract attention all for the singlepurpose of maintaining the status of
the focal point of the public interest. Anyone potentially capable to offer him such
an opportunitymay become a welcomepartnerfor SaakashviIi.
Being the type of a personalitythat exists with the conviction that "he knows best" and is
ready for competitionat any time, he tends to reject any action that he perceives as
contradictory to his publicly expressed views about a particular situation. In order to
motivatehim to act in 8 preferred way he should be convinced that in this particular
situation he is in charge of setting goals and findingways to accomplishthem.

5.1. Be aware of:

Under no circumstance use imperative tone or give him a reason to believe that he is
being humiliated or disrespected and even more so if it is done in public. In
case that he is stuck in controversies it is advisable to anow him to find his way
out in order to save his face and even, if it is needed, offer him a suitable and honourable
rout of escape.
At the same tjrne~it is advisable not to give in all the time. His personality type
respects power and any indisputable authority generates a sense of respect
in him and desire to be part of this force and use it for his own benefit.

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