Not just a tough boss: How toxic leaders harm employee mental health

New research reveals how narcissists and psychopaths can easily climb the corporate ladder.

Evidence is highlighting a concerning trend: A higher prevalence of narcissistic and psychopathic traits among top leaders, and the consequences for employees can be dire.

Prof Renata Schoeman, the head of healthcare leadership at Stellenbosch Business School, says many of the personality traits often associated with psychopaths are also traits that help people get ahead in business, such as charm, fearless dominance, boldness and a grandiose sense of self.

It is estimated that up to 1% of the general population meets the criteria for antisocial personality disorder, yet almost 4% of business leaders may be psychopaths. The CEO level is the career with the highest proportion of psychopaths, second only to the prevalence of antisocial personality disorder among prison inmates (with a 15% prevalence).

The impact on employees can be severe: In SA, a third of employees quit due to toxic leadership, nationwide studies reveal that work-related stress accounts for over 40% of workplace illnesses, and one in four South African employees has been diagnosed with depression.

Schoeman says that although the research paints a bleak picture, it does not mean all leaders are psychopaths or narcissists.

“It’s common for people to use these terms loosely, but we’re not referring to challenging bosses here. Narcissists and psychopaths have distinct, clinically identifiable traits. Recognising these traits accurately is crucial, as misunderstanding can lead to wrongful labelling and conflict.”

What are the signs?

Narcissism: Grandiosity, entitlement, constant need for admiration, lack of empathy, arrogance and hypersensitivity to criticism.

Psychopathy: Superficial charm, manipulative behaviours, lack of remorse or empathy, impulsivity and limited emotional depth.

Schoeman says that these traits, although counterintuitive, are the very characteristics that can be advantageous for leaders and fit many conventional ideas of how ‘leaders’ behave, especially in high-stakes corporate environments.

“Narcissists and psychopaths can easily rise to the top. They have charm, they are fearless and risk-takers – all perceived to be strong leadership traits,” she says.

“Narcissists can be brilliant strategists, have the courage (and even audacity) to push through massive change and transition – despite the risks, and their compelling visions and skill in using their charisma to inspire, attract followers.”

Schoeman says these ‘rising stars’ are masters of self-image, who will take the credit but deflect blame.

“Narcissistic leaders favour indirect strategies, such as withholding information impacting individual performance or isolating staff, while psychopaths rely on direct manipulation and bullying.

“The corporate narcissist will gather a group of co-dependent people around him or her to support and reinforce his or her behaviour. Although narcissists profess to be loyal to the organisation, they are often only committed to their own agenda, not company loyalty. They expect great dedication and may overwork others without any regard for the impact on their lives.”

Schoeman says psychopathic characteristics on the other spectrum show towards aggressive behaviour, where dominance and strategic conquest triumph.

Successful vs criminal psychopaths

“Despite their deceit, pathological lying, manipulativeness, indifference to the consequences of their behaviour, their lack of empathy, callousness, cynicism, impulsivity, irresponsibility, inflated self-appraisal, superficial charm and lack of remorse, some individuals with psychopathy are highly successful.

“What separates psychopaths who become criminals from psychopaths who succeed in business is that they differ in their level of conscientiousness. Successful psychopaths are less impulsive, negligent and irresponsible than the psychopaths who live a life of crime.

“However, this does not imply that successful psychopaths are always law-abiding citizens. They may just be better at avoiding being caught. Successful psychopaths tend to have more privileged backgrounds, higher IQs, and little risk of legal penalties when compared to their unsuccessful (criminal) counterparts.

“They are extremely efficient in using and manipulating communication networks to enhance their reputation, while discrediting others, and creating and maintaining conflicts and rivalries among colleagues. They are excellent at spreading disinformation while covering up their association with this false information, leading others to be ‘blind’ to their involvement. In effect, they are therefore innocent of manipulation.”

Schoeman says that, as inspiring as these leaders can be at first, they create a damaging effect within an organisation.

“Their successes mask the long-term costs: Suppressed innovation, low morale, high attrition, reputational damage and eventually financial decline. Organisations need to be vigilant of these traits as they move through the corridors. By educating staff and ensuring clear HR strategies to manage incidents and support victims, we can rid companies of the toxic environments these leaders cause.”

Safeguarding employees

If you suspect a leader exhibits these traits, here are practical steps employees can take:

  • Establish clear boundaries: Maintain professional distance and document interactions.
  • Seek organisational support: Engage HR or use employee assistance programmes.
  • Prioritise self-care: Ensure you have emotional and social support networks.
  • Stay objective: Evaluate performance clearly, focusing on facts rather than emotions.

If you’re the leader: Reflect and act

Self-awareness is powerful. If you recognise some of these traits in yourself, consider the following:

  • Seek professional guidance: Psychological support can offer strategies for mitigating harmful traits.
  • Solicit authentic feedback: Engage a trusted colleague or mentor to give honest input.
  • Develop empathy and humility: Commit to leadership training that emphasises emotional intelligence and ethical leadership.
  • Transparency and accountability: Create organisational checks and balances to mitigate risks associated with these traits.

What organisations can do:

  • Detect dark traits early with specific psychometric screening for senior roles that measure psychological behaviour.
  • Encourage feedback with anonymous tip lines and exit interviews to help uncover toxic behaviours before they escalate.
  • Emphasise fairness, transparency and open-door policies, diluting power to subtle manipulators.
  • Support employee well-being by investing in wellness programmes, flexible work, mental healthcare access and relevant HR safeguards.
  • Hold leaders accountable with clear consequences for abusive behaviour, with clear protocols and HR and legal interventions.

Schoeman says leadership carries great responsibility.

“Recognising and addressing problematic traits like narcissism and psychopathy not only safeguards organisational health but also cultivates a culture of psychological safety and ethical integrity – ultimately promoting mental well-being and productivity.”

According to Schoeman, personality disorders in leadership aren’t just clinical curiosities.

“They have tangible and destructive impacts on organisational culture and employee well-being. Recognising, intervening, and realigning is not optional – it’s crucial for sustainable, mentally healthy workplaces.”

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Andrea van Wyk

Caxton’s Digital Editorial Manager. I am a journalist and editor with experience spanning over a decade having worked for major local and national news publications across the country and as a correspondent in the Netherlands. I write about most topics with a special interest in politics, crime, human interest and conservation.
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