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The Medical Implications of Nuclear War (1986)

Chapter: 26 The Impact of Crisis-Induced Stress on Decision Making

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Suggested Citation:"26 The Impact of Crisis-Induced Stress on Decision Making." Institute of Medicine. 1986. The Medical Implications of Nuclear War. Washington, DC: The National Academies Press. doi: 10.17226/940.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

The Medical Implications of Nuclear War, Institute of Medicine. ~ 1986 by the National Academy of Sciences. National Academy Press, Washington, D.C. The Impact of Crisis-Induced Stress on Decision Making ALEXANDER L. GEORGE, PH.D. Stanford University, Stanford, California It is remarkable that all U.S.-Soviet diplomatic confrontations over Berlin, Korea, the Middle East, Cuba, and the Indian Ocean have been successfully terminated without any kind of shooting war between U.S. and Soviet forces. The mutual fear of igniting a fuse that could result in thermonuclear holocaust is undoubtedly the major factor that accounts for this success. Moreover, during the 40 years of competing with each other on a global scale, the two superpowers have learned some fundamental rules of prudence for managing their rivalry without becoming embroiled in warfare with each other. At the same time, however, it needs to be recognized that the superpowers have been more successful in managing war-threatening crises than in avoiding them. While the frequency of crises involving the superpowers appears to have declined since the outset of the Cold War and there has been no war-threatening crisis since 1973, it is premature to conclude that the United States and the Soviet Union have learned to manage their rivalry without plunging periodically into dan- gerous confrontations. We cannot exclude the possibility that the super- powers may again be drawn into dangerous war-threatening crises at some point in the future. Concern over the danger of nuclear war has mounted in recent years in response to developments in military technology and changes in force postures. Increased missile accuracies, the deployment and forward basing of highly accurate strategic systems that reduce available warning time, and developments in warning and alert systems raise the possibility of so- called decapitation strikes against vulnerable political and military com 529

530 IMAGES AND RISKS OF NUCLEAR WAR mend posts. As a result of these developments in the strategic military environment in which deterrence must operate, both Amencan and Soviet analysts express increasing concern over the heightened danger of crisis instability and the associated possibilities of inadvertent or accidental war. Given their shared fear of thermonuclear war, American and Soviet leaders can be counted on to be powerfully motivated to manage and terminate any new diplomatic crisis before it erupts into war. Both sides are familiar with the general principles and operational requirements of crisis management. However, mere awareness of crisis management re- quirements does not guarantee that they will be effectively implemented in a new confrontation. It is a genuinely challenging and difficult task for policymakers to adapt knowledge of these general crisis management principles to the specific, idiosyncratic configuration of each new crisis situation (George, 19841. Moreover, given the above mentioned devel- opments that contribute to crisis instability, it has become more urgent than ever to address the question of whether crisis management concepts are robust and flexible enough to withstand the possibly destabilizing and escalatory potential of the military alerts and actions that each side may feel obliged to take to protect their own interests and hedge against the possibility that crisis management may break down in a new confronta- tion. ~ Detailed studies of past crises and simulations of hypothetical ones have enhanced our understanding of various threats to crisis management. While U.S. and Soviet policymakers have effectively avoided or defused these threats in all of their past confrontations, similar threats are certain to arise in future crises involving the superpowers. One of these threats to effective crisis management the possibly harm- ful effects that psychological stress experienced by policymakers during a tense crisis might have on the performance of critical decision-making tasks is the subject of this paper.t *This question was the subject of the 8th Conference on New Approaches to Arms Control held by the International Institute of Strategic Studies in England on April 9-11, 1984. For a report on the conference see Survival XXVI (5):200-234, 1984. On the subject of the need for effective crisis management as a safeguard against inadvertent war, see also Roderick (1983). fin the time available I was able to do little more than to synthesize and summarize material in existing studies which were readily available, including both my own previous publications and those of other investigators (George, 1974, 1980; Holsti, 1972; Holsti and George, 1975; Janis, 1972; Janis and Mann, 1977; Hermann, 1972; Hermann and Hermann, 1975; Suedfeld and Tetlock, 1977). These earlier publications draw on literature produced by psychologists, psychiatrists, political scientists, organizational theorists, sociologists, and historians. To reduce the length of the references for this article, only a few of the sources used in these earlier publications have been cited.

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 531 The problem of assessing and dealing with the impact of crisis-induced stress on policymaking may appear at first glance to be reasonably well- defined and sufficiently bounded to permit focused investigation in a direct and straightforward manner. In fact, however, for this purpose one must draw on many of the behavioral sciences and, indeed, the medical sciences as well. A conceptual framework is needed that will permit integration of the many variables that come into play in decision making in crisis sit- uations, variables that determine whether stress will be experienced and how it will be coped with. Finally, the reader should be aware that despite the effort made in this paper to deal with the many dimensions of the problem, some important matters (the physical and mental health of policymakers) are only touched on, while others (the effects of sleep deprivation and use of drugs and medications during prolonged crises) are not dealt with at all because they require highly specialized competence and knowledge not available for this study. MENTAL HEALTH This study does not reject the possibility that gross irrationalities of the type that concern psychiatrists may occur in top-level policymakers. One need only recall the severe mental illness that afflicted the first secretary of defense, James Forrestal, while he was still in office and led to his tragic suicide shortly thereafter (Rogow, 19631. At the same time it is probably the case that the most serious consequences of illnesses, such as Forrestal's, for policy decisions tend to be checked by various built-in safeguards within the organization: "Most key policy decisions are dis- tributed over a number of persons and a variety of agencies," and there is a tendency within the bureaucracy "to remove or reduce the decision- making authority of the sick individual while leaving him in office" (Rogow, 1969, p. 1096~. Although the possibility that major psychiatric impairment in an official may not be detected or controlled in time to prevent a policy disaster or the additional possibility that crisis-induced stress may suddenly activate latent mental illness are matters for legitimate concern, they will not be the focus of this article. In fact, the conventional wisdom that every man has his breaking point obscures from view the fact that few political leaders actually break down under the stress of making difficult decisions. We need to address the broader and murkier question of the adverse effect performance under stress by leaders who are not ill may have on public policy.

532 IMAGES AND RISKS OF NUCLEAR WAR There is no doubt that most individuals who reach high-level policy- making positions have already acquired relevant experience that provides them with the ingenuity, resiliency, and toughness needed for coping with the stresses of making difficult political decisions. In other words, they have learned to cope with decisional stress. Certainly we would like to know more about the psychological coping mechanisms that help keep political leaders intact and functioning. But the fact that an individual enjoys good mental health does not guarantee that he makes good deci- sions. A relatively well-adjusted man, after all, may be lazy or have limited imagination and adaptability. Therefore, we cannot be concerned solely with the consequences of a leader's decision making for his own emotional well-being. We must be at least equally concerned with the consequences for others, for the psychological coping mechanisms a decision maker employs to maintain his own equilibrium may be dysfunctional for the group or polity on whose behalf he has acted. At the same time, we need to recognize that even successful political leaders who have functioned effectively in the past sometimes do suffer breakdowns under the pressure of crisis-induced stress (see below). As Richard Ned Lebow has suggested (personal communication, October 3, 1985), developments during a crisis may generate threats to the individ- ual's self-esteem and activate latent vulnerabilities in his personality struc- ture that undermine his capacity to function effectively. STRESS AND COPING: IMPACT ON INFORMATION PROCESSING It has been found to be necessary in research on stress to distinguish sharply between the properties of a stimulus situation and the character- istics of the behavioral response to it by the individual or group. (Confusion may be generated by the familiar habit of characterizing an event as a stressful situation because this confounds the properties of the stimulus situation with certain kinds of effects it may have on the subject.) It is customary to regard psychological stress as the anxiety or fear an individual experiences in a situation that he perceives poses a severe threat to one or more of his values. Thus perception of threat in the situation must occur in order for the individual to experience arousal of anxiety or fear. Threat, in other words, is not an attribute of the stimulus situation; it depends on the subject's appraisal of the implications of the situation for his values. Anxiety and fear, however, do not have a direct impact on decision making; they are mediated by other intervening variables. Research on the effects of situationally induced stress on decision making has increas

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING Stress Perception Anxiety Stimulus~ of threat - ~ or situationtovalues fear FIGURE 1 Effects of stress on decision making. i 533 Impact on Coping ~ information pattern processing Choice of decision or policy ngly focused on coping patterns as an additional intervening variable between the subject's experience (or anticipation) of anxiety and fear and his performance of information-processing tasks that typically precede his decision or choice of policy. It is important to recognize that a variety of coping patterns can be employed for dealing with psychological stress. Some of these will be discussed below. Coping patterns may have deep roots in personality or they may be learned. Different individuals may favor different modes of coping. Coping includes not merely an individual's resort to ego-defensive maneuvers (e.g., withdrawal, denial, projection, rationalization) to main- tain emotional well-being but also the individual's employment of those other ego processes at his disposal that facilitate a reality-oriented approach to dealing with situational and task demands and for effective environ- mental management. Moreover, developments in the study of the nature of coping processes (e.g., Murphy, 1962; Janis, 1958; Hamburg and Adams, 1967) indicate that many of the classical ego defense mechanisms can be used construc- tively by an individual in the total process of coping. An initial resort to defensive operations such as withdrawal, denial, or projection does not preclude that individual from going on to make a timely and reasonable adaptation to a difficult situation. * Defensive operations, in other words, may give the severely stressed individual time to regroup his ego resources and provide him with the immediate tactical ego support that enables him in due course to employ more constructive ego capacities of information seeking, reality appraisal, role rehearsal, planning, and so on. But time must be available to permit recovery of adequate functioning, and one cannot be certain of this in crises that occur suddenly and require immediate responses from decision makers (see below). Therefore, study of the effects of stress on decision making needs to be conceptualized as a multistage process (Figure 11. *Note, for example, Harry Truman's tendency to resort to projection as his initial method of coping with certain kinds of political stresses before turning to a more constructive, reality-oriented coping strategy. A particularly vivid example is Truman's initial response to the news of the Chinese intervention in the Korean War, for which he impulsively blamed his Republican opponents, before settling down to deal with the crisis (Hersey, 1951). 1

534 IMAGES AND RISKS OF NUCLEAR WAR EFFECTS OF STRESS ON PERFORMANCE: THE INVERTED U CURVE Research on the effects of stress on performance of various tasks leads to the general finding of an inverted U-curve relationship between the magnitude of stress and performance of various tasks (Hermann and Her- mann, 19751. That is, up to a point situationally induced stress can lead to an improvement in the performance of various tasks. If it increases beyond a certain magnitude and duration, however, stress can begin to markedly impair the ability of decision makers and their staffs to make realistic assessments of the situation and to exercise good judgment in dealing with it (Holsti, 19721. The relationship can be depicted as shown in Figure 2. It should be kept in mind that the inverted U curve depicts a highly variable general relationship between intensity of stress and level of per- formance. Its value for practical purposes is limited for a number of reasons: (1) The precise shape of the curve can be expected to differ from one individual to another; (2) for the same individual the threshold, or crossover, point at which increased stress begins to become dysfunctional can be expected to differ for different tasks; (3) for the same individual performing the same task, the threshold crossover point can be expected to vary, depending on circumstances and factors that vary from one trial to another; (4) whether the individual performs in a group and the nature a' . cat LL UJ > 111 J 7 CC o 11 UJ threshold / a, . _ cot a' - / Low I NTENSITY FIGURE 2 Effects of stress on performance. High

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 535 of the group (composition, structure, decision-making norms, leadership and management, group dynamics) also can be expected to affect the shape of the curve. For these and other reasons, the vast experimental literature on stress, while highly suggestive, must be used with caution by those who study decision making. As Holsti and George (1975) note: "Relatively few of these laboratory studies have involved more complicated cognitive pro- cesses or highly intellectualized tasks that often confront the policymaker. Subjects have usually been students, who differ by virtue of age and experience from political leaders.... Many experimental studies isolate the subject, rather than placing him into the context of groups or orga- nization-both of which may provide the political leaders with supports and/or constraints in performing the required decision making tasks" (p. 2581. INDICATORS OF ACUTE STRESS AND ITS CONSEQUENCES It would be helpful, of course, if valid and reliable behavioral or phys- iological indicators that correlate with dysfunctional levels of stress could be identified. Some possible verbal and nonverbal indicators e.g., flus- tered speech, increased speech tempo, body tension, irritability, rigidity of speech content, verbal and behavioral withdrawal have been sug- gested as candidates for systematic investigation (Hermann and Herrnann, 19751.* But the difficulty of establishing valid general indicators that apply to large populations or, somewhat more feasibly, to a single designated individual appears to be formidable; however, this dimension of the prob- lem lies well outside the scope of this paper. An alternative to seeking physiological and behavioral indicators of acute stress in the individual, however, may be considered. Thus, one may seek to identify the consequences of acute stress experienced by the individual or group as they manifest themselves in the phenomenology of the decision-making process. There are at least two ways in which this can be done. First, the investigator can begin by stating the critical tasks that should be adequately performed in any well-designed, well-managed policymaking system; and then, using these critical tasks as a standard, the investigator can identify possible malfunctions of the process-i.e., the inadequate performance of one or more of these critical tasks. (This approach is elaborated and discussed in some detail by George t1980; see *See also Wiegele (1973) for a discussion of biological factors, and Suedfeld and Tetlock (1977) for the utility of a measure of changes in an individual's integrative complexity in . . a crisis.

536 IMAGES AND RISKS OF NUCLEAR WAR especially Chapter 6~.) A limitation of this approach is that it does not distinguish among the various possible sources, of which acute stress is only one, of a malfunctioning policy process. (The impact of bureaucratic politics, for example, may also create malfunctions of the policymaking process.) On the other hand, this approach does offer the custodian or manager of the policymaking system a usable basis for undertaking a variety of preventive and therapeutic interventions to forestall or com- pensate for malfunctions that could have adverse impacts on the quality of the decisions to be taken (George, 1980; in particular Part Two: Ways of Reducing Impediments to Information Processing). The second approach focuses directly on the possibly adverse conse- quences of acute stress experienced by the individual or the group for the performance of cognitive tasks required for effective information pro- cessing. Dysfunctional effects of acute stress include impaired attention and perception, increased cognitive rigidity, shortened and narrowed per- spective (see below for a more complete discussion). These two ways of identifying the effects of acute stress are not mutually exclusive; in fact, they complement each other. The second approach focuses specifically and exclusively on stress as a source of cognitive impairment. (Cognitive impairment, in turn, can lead to one or another of the malfunctions of the policymaking process identified in the first approach.) But, as already noted, the first approach focuses on the mal- functions of the process, irrespective of their source or sources. Therefore, not only is the first approach more comprehensive but it offers a practical way of identifying and dealing with a variety of threats to information processing. THE POLICYMAKING SYSTEM: THE INDIVIDUAL, SMALL GROUP, AND ORGANIZATION SUBSYSTEMS To study the effects of stress on foreign policymaking requires a con- ceptual framework that takes into account individual, small group, and organizational behavior within the executive branch. Efforts at rational calculation and choice of policy take place in three interrelated contexts or subsystems: the individual context (e.g., the chief executive, secretary of state); the small group context of the face-to-face relationships the executive enters into with a relatively small number of advisers; and the organizational context of hierarchically organized and coordinated pro- cesses involving the various departments and agencies concerned with foreign policy matters in the executive branch.* *I will not attempt to deal with still other subsystems that interact with the three noted here i.e., Congress, public opinion, and allied and neutral governments.

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 537 The investigator must take into account the fact that these three sub- systems are interrelated. Thus, the individual-executive, the small deci- sion-making group, and the organizational units often interact with each other in producing foreign policy outputs. Accordingly, a conceptual framework is needed that will incorporate and interrelate these three sub- systems, each of which is capable of generating a special set of adaptive and maladaptive ways of coping with the impact of stress on decision making. The research task is to identify the distinctive dynamic processes associated with each of these subsystems and to consider how these pro- cesses can have a favorable or adverse impact on the other two subsystems. The task outlined here is indeed a formidable one. Despite advances in theories of individual psychology, small group dynamics, and organiza- tional behavior, the linkage and synthesis of these three theories is still primitive. In a previous study the author employed information processing as a framework for this purpose (George, 19801. A familiar depiction of information processing identifies three functional tasks: search, evaluation, and choice. Information must be acquired and evaluated to achieve a valid, incisive diagnosis of the situation to which the chief executive must re- spond. The major values and interests affected by the situation must be identified. If options cannot be invented that promise to further all of the values and interests at stake, trade-offs among competing values must be considered. The expected consequences of alternative options must be assessed prior to the choice of action. Working with an information-processing framework, the investigator is in a better position to assess the contribution each of the three subsystems makes to the tasks of search, evaluation, and choice; in addition, the investigator is better able to assess the way in which the three subsystems interact in information processing. Each of the subsystems is capable of contributing constructively to the fulfillment of information-processing tasks or generating impediments to those tasks. It is also possible for the workings of one subsystem to block, or compensate for, the impediments to information processing generated by another subsystem. The distinctive dynamic processes associated with each subsystem and the ways in which they can adversely or favorably affect information-processing tasks are described elsewhere (George, 1974; Holsti and George, 1975; George, 19801. COPING WITH VALUE COMPLEXITY AND UNCERTAINTY It is important to recognize that cognitive constraints on rational decision making (e.g., March and Simon, 1958) may themselves create stress for the individual who is attempting to judge the utility of alternative courses of action in situations in which important values are engaged. One of the

538 IMAGES AND RISKS OF NUCLEAR WAR well-known cognitive limits on rationality is the difficulty of formulating a single utility criterion or function that will encompass all the multiple values engaged by the particular problem. If a decision maker lacks a single utility function, he is apt to experience motivational conflict and must cope in some other way with the stressful dilemma of multiple stakes (which will often include personal, political, and organizational values, as well as national interest and ideological values). The decision maker can attempt to cope with this particular type of decisional stress by various psychological and bureaucratic devices for either avoiding or resolving the dilemma of determining how to judge which course of action is best. The other well-known and equally pervasive cognitive constraints on rational decision making have to do with inadequate information about the situation at hand and inadequate knowledge with which to assess the expected consequences of alternative options. Forced to act in the face of these uncertainties, when so much may be at stake, the decision maker may experience considerable stress. Various ways of coping with the resulting cognitive complexity of the decisional problem have been iden- tified. Thus, the decision maker may resort to defensive avoidance, a device that permits an escape from having to recognize the decisional dilemma. Defensive avoidance can take the form of procrastination: the policymaker seizes on the presumed fact that there is no immediate ne- cessity for a decision to put the problem out of his mind, even foregoing the opportunity for additional information search, appraisal, and realistic contingency planning (for a detailed discussion, see Janis and Mann t19771~. Another type of defensive avoidance, bolstering, may be resorted to when a decision is difficult to make, when it threatens great loss, or when it cannot be put off because external pressures or a strict deadline demands action. Under these circumstances the policymaker may make the task of choosing an option easier for himself by reevaluating the courses of action before him, increasing in his mind the attractiveness of one option (which he will then select) and doing the opposite for competing options (which he will then reject). Bolstering, also known as spreading the alternatives, can result in distorted information processing and option appraisal. This is particularly likely to occur when the policymaker, acting to cut short the malaise and stress of having to make a difficult decision when much is at stake, needlessly rushes to make his final choice, thereby losing the possibility of using the available time to obtain still additional information and advice. Supportive bolstering by sycophantic (or equally stressed) subordinates to the top decision maker can aggravate this danger of the premature closure of information processing. In addition to these modes of defensive avoidance, which provide psy- chological assistance to enable a policymaker to come to a decision, there

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 539 are a variety of analytical aids and simple decision rules that the policy- mal~er may rely on to cope with the intellectual task of what to do in the face of the cognitive complexity that clouds the problem. At least seven such analytical aids have been identified as having been employed by political decision makers under these circumstances: (1) the use of a "sa- tisficing" * rather than an "optimizing" decision rule; (2) the strategy of incrementalism; (3) He strategy of sequential decision making; (4) consensus politics i.e., deciding on the basis of what enough people want and will support rather than by trying to master the complexity of the policy issue; (5) use of historical analogies and lessons of history; (6) reliance on one's ideology and general principles as guides to action; (7) applying one's general beliefs about correct strategy and tactics (George, 1980; see also discussion of Decision-Making Strategies, Chapter 2, in Janis and Mann t197711. While these aids to decision making can facilitate the policymaker's choice of action, they can also have adverse consequences for the quality of information processing. The danger is that an executive will resort prematurely to one of his favorite aids to decision or rely too heavily on it in deciding what to do. The result may well be to cut himself off from the possibility of benefiting from a broader or in-depth analysis of the problem that advisers or the organization can provide." IMPACT OF CRISIS-INDUCED STRESS ON FOREIGN POLICY DECISION MAKING Several characteristics of international crises can arouse acute anxiety and other strong emotional feelings, such as fear, shame, anger, and aggressiveness. First, by its very nature an international crisis poses a major threat to national interests that top-level decision makers are re- sponsible for safeguarding. But much is at stake in a crisis also for the political leader: Will he prove equal to the challenge? Will he be able to *The term satisfice, coined by Herbert A. Simon, suggests that decision makers will not strive endlessly to reach the optimal position but, instead, will discontinue the search for better solutions after a threshold level of satisfaction 'has been reached (Simon, Herbert A. February 1955. A behavioral model of rational choice. Quarterly Journal of Economics, Vol. 69). lThis is particularly likely to occur when, under the impact of crisis-induced stress, decision makers attempt to cope via the pattern of what Irving L. Janis (1985) has char- acterized as hypervigilance, i.e., when the decision maker '`in a panic-like state searches frantically for a way out of the dilemma, rapidly shifting back and forth between alternatives, and impulsively seizes on a hastily contrived solution that seems to promise immediate relief."

540 IMAGES AND RISKS OF NUCLEAR WAR deal with the crisis in ways that will safeguard his sense of personal worth, assure him the esteem and respect of others, and protect his own and his party's political interests? Second, crises often erupt unexpectedly, and the resulting shock and surprise can have harmful effects on a policymaker's ability to assess the situation calmly and to exercise good judgment. A third stress-inducing characteristic of many crises is that they require (or are perceived by policymal~ers to require) a quick decision. A short response time can impose an additional psychological burden on decision makers and their advisers. Fourth, there is the factor of cumulative emotional strain and physical fatigue that a prolonged confrontation imposes on policymakers and their staffs. A crisis imposes intense demands on the energies and emotions of the participants, and at the same time, there are limited opportunities for rest and recuperation. As noted above, moderate amounts of stress may lead to improved performance. Perception of threat may be followed by heightened vigilance that facilitates information search, receptivity to relevant information, and balanced assessments (Janis and Mann, 1977~. Detailed case studies of decision making in international crises have provided empirical evidence that, in important respects, the quality of decision malting is often im- proved or remains generally at high or acceptable levels (Brecher and Geist, 1980; Shlaim, 1983; Dowty, 1984; Dawisha, 19851.* On the other hand, other historical cases provide evidence of We dam- aging impact of cnsis-induced stress. For example, the literature on Amer- ican policymaking during the Cuban missile crisis offers testimony on the adverse effects cr~sis-induced stress had on the functioning of several members of the policymaking group. Theodore Sorensen, a participant in President Kennedy's circle of advisers during the cnsis, subsequently made the cryptic statement that he had seen at firsthand, "dunng the long days and nights of the Cuban crisis, how brutally physical and mental fatigue *These references comprise the first four volumes published thus far in the important collaborative research project on International Crisis Behavior, under the direction of Mi- chael Brecher, that is evaluating the effects of crisis-induced stress on the quality of decision making in a large number of historical cases. A limitation of these studies stems from the difficulty of obtaining a direct measure of the magnitude of stress experienced by individual policymakers; as a result, the investigator cannot easily differentiate moderate stress from acute stress. Earlier, pioneering research on the stress-inducing effects of international crises was done by Robert North and associates at Stanford University. A useful formulation of the findings of the Stanford project is provided by Holsti (1972). Important contributions also appear in several publications by Charles F. Hermann (1969, 1972). A detailed ex- amination of Israeli decision making in the events leading to the Six-Day War of 1967 concludes that its quality was rather mixed (Stein and Tanter, 1980).

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 541 can numb the good sense as well as the senses of normally articulate men" (Sorensen, 1964; p. 761. A similar observation was made by Robert Ken- nedy in his memoir of the Cuban crisis: "That kind of crisis-induced pressure does strange things to a human being, even to brilliant, self- confident, mature, experienced men. For some it brings out characteristics and strengths that perhaps even they never knew they had, and for others the pressure is too overwhelming" (Kennedy, 1969; p. 221. Details of what happened were lacking for many years. In 1984 I was told by a high official in the Kennedy administration that two important members of the president's advisory group (whose names were not revealed) had been unable to cope with the stress, becoming quite passive and unable to fulfill their responsibilities. Their condition was very noticeable, however; others took over their duties, and the performance of the policymaking group during the missile crisis is generally regarded as of a high order. Inability to cope with crisis-induced stress has been reported for other leaders as well. Stalin evidently suffered a temporary depression after the Nazi invasion of the Soviet Union in 1941. British Prime Minister Eden reacted to the failure of the Suez invasion in 1956 with a near physical and emotional collapse (Thomas, 19671. At one point in the prolonged crisis leading to Israeli initiation of war against Egypt and Syria in June 1967, Israeli Army Chief of Staff Yitzhak Rabin, visibly overstressed or suffering from nicotine poisoning, was temporarily relieved of his duties (Brecher, 1980; Stein and Tanter, 1980; Weizman, 1974; Rabin, 1979~. In the aftermath of their countries' military setbacks in 1962 and 1967, respectively, India's Jawaharlal Nehru and Egypt's Gamal Abdel Nasser were mentally and physically incapacitated (Lebow, in press). In all the cases cited here, the dysfunctional effects of stress on the policymaker were highly visible and could be easily recognized by others, thus providing opportunities for timely intervention and compensatory action. But undue stress can also have less visible but nonetheless insidious effects on the performance of decision making. A great deal is known about the ways in which acute psychological stress degrades performance of cognitive and judgmental tasks of the kind that policymakers must discharge in a crisis. In Table 1 is a brief summary of major types of effects that have been noted. Evidence of many of these effects of stress was noted in a detailed analysis of historical materials on the origins of World War I. As sum- marized by Holsti (19721: Evidence from the 1914 crisis revealed that with increasing stress there was a vast increase in communication; information which did not conform to expecta- tions and preferences was often disregarded or rejected; time pressure became an increasingly salient factor in policy making; attention became focused on the

542 IMAGES AND RISKS OF NUCLEAR WAR TABLE 1 Effects of Acute Stress on Performance of Complex Cognitive Tasks of Decision Making 1. Impaired attention and perception a. Important aspects of crisis situation may escape scrutiny b. Conflicting values and interests at stake may be overlooked c. Range of perceived alternatives is likely to narrow but not necessarily to the best option d. Search for relevant options tends to be dominated by past expenence; tendency to fall back on familiar solutions that have worked in the past, whether or not they are appropriate to present situation 2. Increased cognitive rigidity a. Impaired ability to improvise; reduced creativity b. Reduced receptivity to information that challenges existing beliefs c. Increased stereotypic thinking d. Reduced tolerance for ambiguity leading to cut off of information search and premature decision 3. Shortened and narrowed perspective a. Less attention to longer-range considerations and consequences of actions b. Less attention to side-effects of options 4. Shifting the burden to the opponent a. Belief that one's own options are quite limited b. Belief that opponent has it within his power to prevent an impending disaster immediate rather than the longer-range consequences of actions and one's alter- natives and those of allies were viewed as limited and becoming more restricted with increasing stress, whereas those of the adversary were believed to be relatively free from constraints. As a consequence European statesmen felt a declining sense of responsibility for their actions and the consequences to which they might give rise. These findings clearly deviate rather sharply from some of the common precepts of calculated decision making (p. 2001. IMPACT OF STRESS ON SMALL GROUP DYNAMICS The various conformity-inducing dynamics of behavior in small groups are well-known and need not be recapitulated here (e.g., DeRivera, 19681. It is useful to distinguish two behavioral patterns that produce conformity which in turn may create an impediment to the quality of information processing. The first is the familiar pattern of group pressure on individual members who raise nettlesome, disturbing questions that undermine the confidence of the group that it is on the right track, thereby challenging the emerging consensus. This can occur even in the absence of crisis- induced decisional stress but may become pronounced under the impact of a tense international crisis.

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 543 The second of the behavioral patterns producing and maintaining con- formity within small decision-making groups has been less well articulated and studied, no doubt because the group processes associated with it are more subtle. Without detracting from the importance of the first pattern, we may agree with Marlowe and Gergen (1969) that it is unsatisfactory and "unduly restrictive" to view conformity solely within "the narrow context of a group exerting pressure on individuals, some of whom are susceptible (or suggestible) and consequently conforming" (p. 6101. A broader perspective can be gained by observing that small decision-making groups sometimes take on the characteristics of a primary group. Soci- ologists and psychologists who have studied the remarkable cohesion that develops at times in small combat groups in military organizations have noted the special kinds of mutual identifications and emotional ties that bind members of the primary group together and sustain individual mem- bers in coping with the stresses of combat (e.g., Shils and Janowitz, 1948; Janis, 19631. A number of participant observers, including Bill Moyers and George Reedy, commented on the tendency of President Johnson's top-level policymaking group on the Vietnam War to take on some of the characteristics of an embattled group in order to protect itself from critical views. Though it may seem farfetched to apply the analogy of a combat group to a small political decision-making group, it is well-known that chief executives often rely on primary group ties with one or more close as- sociates or friends as a means of coping with the stresses of decision making. From membership in the small intimate group, the individual may secure some of the psychological support esteem, respect, reas- surance, affection needed to sustain him in his efforts to cope with the cognitive complexity, the uncertainty and risks, and the criticism from outsiders that are inevitably a part of political decision making. The chief executive himself may become dependent for emotional support on policy advisers. Some chief executives, however, are evidently aware of the risks of doing so; thus, Woodrow Wilson could accept Colonel House as both a friend and a policy adviser only because House occupied no official position (George and George, 19561. Calvin Coolidge "found it necessary to keep his friend Frank Stearns around him as a kind of buffer-companion- confessor, yet he would not work through him or consult him in any way" (Fenno, 1959, pp. 42-431. Adlai Stevenson noted that Lyndon B. Johnson was very uncomfortable if none of his policy advisers wholly approved of a decision he had just made (Geyelin, 19661. Janis (1972) hypothesizes that concurrence seeking in small decision- making groups "can best be understood as a mutual effort among the members of a group to maintain self-esteem, especially when they share

544 IMAGES AND RISKS OF NUCLEAR WAR responsibility for making vital decisions that raise threats of social dis- approval and self-disapproval" (p. 2031. This striving for mutual support, Janis postulates, has functional value for the members insofar as it alle- viates distressing emotional states such as feelings of insecurity or anxiety about risks and possible errors, conflicts between different standards of conduct, between ethical ideas and humanitarian values on the one hand and the utilitarian demands of national or organization goals. I noted earlier that one of the major cognitive constraints on rational decision making arises from the fact that it is often difficult to formulate a single criterion of value to apply in choosing the best course of action. Janis suggests that under these circumstances, and particularly in highly cohesive groups, group concurrence tends to replace reality testing of the morality and efficacy of the policy being chosen or pursued. Earlier, Schachter (1960) had postulated that on any issue for which there is no empirical referent, the reality of one's own opinion is established by the fact that other people hold similar opinions. In Janis's theory, strong cohesion facilitates the emergence of what he calls groupthink, a way of coping with stress that is likely to be highly maladaptive for rational decision making. Groupthink is characterized by a shared "illusion of invulnerability," an exaggerated belief in the com- petence of the group, a "shared illusion of unanimity" within the group, and a number of other symptoms. It would appear that under acute stress and other conditions, the existence of strong primary group ties within a small decision-making group can encourage regressive forms of thinking (as well as regressive emotional states), such as the following: (1) global or undifferentiated thinking, that is,; a simplistic cognitive view of the external world and of other political actors; (2) dichotomized modes of thought; (3) oversimplified notions of causation; (4) loss of sense of pro- portion; and (5) confusion of means with ends. Regressive forms of think- ing are recognizable from time to time in small cliques of fanaticized policy advocates who fight for a certain highly valued policy option in the face of great and persistent difficulties. Janis deliberately challenges the conventional wisdom that group cohe- sion always favors performance of group tasks. Though recognizing the usefulness of strong group cohesion, he warns that it can have an adverse impact on the group's performance: "The more amiability and esprit de corps among members of an executive group, the greater the danger that independent critical thinking will be replaced by groupthink." The very fact that a group of decision makers enjoys strong cohesion may lead to an erosion of critical intellectual capacities when they resort to concurrence seeking in a stressful decision-making environment. This is a far more

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 545 subtle and insidious thing than is the social pressure to conform that is exerted against a member of the group who entertains dissident policy views. IMPACT OF STRESS ON ORGANIZATIONAL BEHAVIOR* Many of those who have examined decision making from an organi- zational perspective note that stressful situations often provide the moti- vation and means for reducing information pathologies and rigidities associated with the normal bureaucratic behavior familiar in complex organizations characterized by hierarchy, specialization, and centraliza- tion. Under circumstances of stress, information search within the orga- nization tends to become more extensive and intensive, although this may not be the case if the time to make the decision is unduly short (as may be the case in some international crises). Similarly, some of the constraints on rational decision making derived from the formal organizational struc- ture, standard operational procedures, and informal bureaucratic political maneuvers may become less potent under the impact of externally stressful events. On the other hand, negative consequences of stress for search behavior have been noted when an organization is subjected to frequent or perpetual crises. It is important to note, too, that information search and appraisal may be adversely affected by existing organizational mind sets, doctrines, and contingency plans in the various departments and bureaus. Under the pressure of a tense crisis, for example, existing contingency plans may be applied without modification to a situation that, as is often the case, is different in important respects from the contingency that was planned for. The more frequent the crises and the less time available for adaptation of contingency plans and for creative improvisation, the more likely that preplanned, ready-to-go options are applied mechanically. And the more emphasis that is placed on secrecy, the less likely that an organizational subunit's existing, preferred options for dealing with the type of contin- gency in question will be subjected to searching scrutiny by others on behalf of the top executive before he is called on to approve. Stress may become dysfunctional also if, as can happen in fast-moving international crises, it is accompanied by an acute information overload that impairs the adaptive capacities of the organization. *This section briefly summarizes and adds to material presented by Holsti and George (1975).

546 IMAGES AND RISKS OF NUCLEAR WAR TOWARD PRESCRIPTIVE THEORY* A broad conceptual framework has been presented for studying the impact of crisis-induced stress on decision making, and available empirical findings have been briefly summarized. Opportunities for systematic in- vestigation of this problem in real-life settings are quite limited, and as noted earlier, the experimental literature on stress, while suggestive, must be used with caution by those who study decision making. Despite its well-known limitations, anecdotal historical case material is useful; the opportunities for improving the quality and increasing the quantity of such raw data have hardly been exhausted. But while the development of an improved data base and better theory is to be encouraged, one cannot be sanguine over the prospects for rapid progress. Those who turn to the task of developing prescriptive theory and guidelines for reducing the incidence and consequences of maladaptive ways of coping with crisis-induced stress will have to work with the limited data and theories that are available. The challenging task is not merely to find useful measures for stress reduction and for avoiding possibly damaging effects of acute stress on policymaking but to find ways of introducing them into the policymaking system. It is useful to begin by recognizing that many factors other than stress can and do affect the quality of foreign policy decisions. These factors include the intelligence and experience of policymakers, the quality of information and advice available to them, and the relevance and validity of the tacit or explicit international relations theories that they employ in their decision malting. A useful prescriptive theory is unlikely to emerge from a narrow-gauge search for a single optimal strategy that would minimize stress-induced impediments to information processing. Top-level policymakers vary greatly in personality and cognitive style which, in turn, leave them with different assets and vulnerabilities in coping with stress. Consider, for example, the freewheeling, extroverted, and often seemingly impulsive decision- making style of Franklin D. Roosevelt and contrast it with the more orderly, introverted, and compulsive style of Richard M. Nixon. These styles of behavior are well-established by the time an individual reaches top leadership positions. Because each style has its special strengths and vulnerabilities, a single set of guidelines is unlikely to prove adequate, even though some procedural norms may apply irrespective of individual variations in style and personality. . *This section reproduces, with some additions and deletions, the discussion of Holsti and George (1975; pp. 304-308). Reprinted with permission from Macmillan Publishing Company from Political Science Annual: An International Review, Volume 6, edited by Cornelius P. Cotter. ~)1975 by Macmillan Publishing Company.

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 547 It is useful to regard the task of avoiding the adverse effects of acute stress as embedded in the larger problem of improving the quality of information processing. As noted above, this requires attention to the interrelations among the individual, small group, and organizational com- ponents of the overall policymaking system. Each of these subsystems is capable of generating impediments to effective information and providing corrections to impediments stemming from the other two subsystems. Recognition of this fact is a useful starting point for the design and man- agement of a complex policymaking system. Prescriptive approaches will be facilitated by taking into account the relevance of two different theories: substantive and process. Substantive theory deals with-problems that arise repeatedly in foreign policy for example, deterrence, coercive diplomacy, crisis management, alliance management, and foreign aid. If policymakers have access to sophisticated substantive theories, they are likely to diagnose situations more adequately and to choose more effective policy options. The availability and use of an appropriate substantive theory is likely to reduce the policymakers' vulnerability to possibly disruptive stresses that are present in such situ- ations. Thus, for example, the stressful aspects of an intense international crisis are more likely to be contained if policymakers guide their actions with reference to general principles of crisis management and become sensitized to the difficulties of applying these principles in concrete sit- uations. (For a summary of crisis management principles and threats to effective management of crises, see George [19841.) Process theory, on the other hand, deals with the question of how to structure and manage the policymaking process to increase the likelihood of producing quality decisions. The availability of even good substantive theory cannot by itself ensure quality decisions-information must still be acquired and processed to achieve a valid, incisive diagnosis of the situation; relevant policy options must be identified and properly analyzed so that substantive theory can be employed to sharpen the judgment that enters into the choice of a course of action. A closer look at process theories identifies two variants: one that focuses on improving the structural design of policymaking systems and one that places emphasis on the day-to-day management of policymaking systems within any given structural design. Despite numerous reorganizations of the machinery and procedures of foreign policymaking in the past, the resulting improvements in policy performance have been marginal and uneven. While structural reorganization can aid in the quest for effective decision making, there is no single structural formula through which the chief executive and his staff can convert the functional expertise and diversity of viewpoints within and outside the executive branch into con- sistently effective policies and decisions. This sober observation coincides

548 IMAGES AND RISKS OF NUCLEAR WAR with the evaluation of a broader range of experience in many different kinds of complex organizations. As a result, organizational theorists have increasingly emphasized that efforts to improve policymaking must go beyond the traditional tinkering with organizational structure and standard operating procedures to (1) the development of strategies for managing the policymaking system and (2) the identification of mechanisms for timely identification and correction of the kinds of malfunctions to which all complex organizations are prone. Because individual executives vary widely in their tolerance for and ability to deal with decisional stress, it is not easy to develop a general prescriptive theory on how the individual can help himself cope more effectively with such circumstances. Many of the decision-making strat- egies mentioned earlier (e.g., satisficing, incrementalism, use of historical models, reliance on ideology or principles) that are available to an ex- ecutive for coping with the complexity of the cognitive tasks of policy- making carter with them the danger that he will resort to one of these strategies prematurely, thereby cutting short or misusing the organizational search and evaluation activities that should precede choice of policy. The difficulty an executive experiences in dealing with cognitive com- plexity and other stresses of policymaking also makes him more vulnerable to certain types of small group dynamics that emerge within his circle of advisers. The criterion of what these significant others will approve may easily fill in the vacuum created for him by the difficulty he encounters in trying to make a good cognitive appraisal of the policy issue. There are some useful things an executive can do to safeguard against his and his associates' tendency to allow this pervasive and deep-seated tendency for concurrence seeking to warp the reality testing needed for developing sound policies (Janis, 19721. But one must also recognize the possibility that an executive who is highly sensitive to the danger of becoming overly dependent on his advisers may overcompensate in order to safeguard against the possibility that his judgment will be unduly affected by advisers whom he has accepted as significant others. An executive may thereby deprive himself of the full contribution that competent advisers might be able to make to improve the quality of his decisions. Political scientists need to give more attention to the ways in which executives with different cognitive styles and personalities can structure role relations with advisers in order to preserve autonomy needs (or indulge dependency needs) with- out distorting the intellectual contribution competent advisers can make to policy analysis. We need to understand better the ways in which an executive's latent capacity for good reality testing and effective problem solving might be reinforced by certain kinds of benign small group processes. How can

IMPACT OF CRISIS-INDUCED STRESS ON DECISION MAKING 549 such processes be encouraged and protected against other small group dynamics that block rational policymaking? What kinds of interventions will effectively improve the quality of decision making? The norms that comprise the problem-solving culture of the small group of policy advisers around the executive seem to be critical here. To assist the executive, there are procedural norms that regulate the performance of the many subtasks undertaken when a small group engages in policy analysis. Various devices have been considered for structuring the small poli- cymaking group to strengthen its capacity for rational decision making in stressful situations. In this connection, a strong case has been made for the use of a devil's advocate. But one cannot be sanguine about the efficacy of devil's advocates in foreign policymaking on the basis of some recent experience (Thomson, 1968; Reedy, 19704. There is reason to believe that the treatment of dissidents is more complicated in real-life decision-making groups and admits to a wider variation in consequences for group per- formance than theories of group conformity pressures based on laboratory research seem to envisage (George, 1980~. It is often emphasized that the organizational subsystem has latent re- sources which, if properly utilized, could enhance the ability of the ex- ecutive and the small group of top-level advisers around him to cope more effectively with the difficulties and stresses of policymaking. For example, in stressful situations they may be inclined to reduce the range of values considered or to order the priorities among them incorrectly, thereby distorting the evaluation and choice of alternative policy options. The organization subsystem provides a possible correction to this tendency. A wider range of relevant values and interests is likely to be surfaced by the clash over policy on the part of officials identified with different subunits within the organizational subsystem. However, internal competition and disagreement over policy within the organization i.e., bureaucratic pol- itics-also can have dysfunctional effects on policymaking. Prescriptive theory at this level therefore must include the task of identifying man- agement strategies for curbing the harmful dynamics of bureaucratic pol- itics (George, 1980~. Finally, it should be noted that the required capabilities and preparations for crisis management cover a broad gamut, extending all the way from knowledge of the political and operational requirements for crisis man- agement to the ability of top-level civilian leaders to direct and control, as necessary, the actions of tactical military units in the field without engaging in harmful micromanagement of military operations. A great deal of essential knowledge and relevant experience bearing on these matters should have been gained from managing past crises. But the learning experience and the acquired know-how must somehow be codified

sso IMAGES AND RISKS OF NUCLEAR WAR and institutionalized; it must be transmitted quickly and effectively to new incumbents of top-level policymaking positions in each administration; and it must be internalized by them so that they will do well the first time they are called on to manage a cnsis. In this connection, consideration should be given to developing sophisticated training and rehearsal exer- cises to better acquaint policymakers with the kinds of difficult tasks of crisis management they will encounter in future U.S.-Soviet confronta- tions. Finally, as suggested earlier in this paper, the medical support system available to top-level policymakers should be reviewed and up . graded, if necessary, to provide effective monitoring and guidance in matters of stress reduction, avoidance of debilitating fatigue from over- work and inadequate sleep, and appropriate advice on the use of sleeping pills and amphetamines during prolonged, intense crises. ACKNOWLEDGMENTS I am pleased to acknowledge support from The Carnegie Corporation of New York and the Center for International Security and Arms Control at Stanford University which made the preparation of this paper possible. For much help and encouragement over a period of many years in my efforts to understand the effects of psychological stress on political decision making, I express appreciation particularly to David A. Hamburg, Charles Herrnann, Margaret Hermann, Ole Holsti, and Irving L. Janis. For helpful comments on an earlier draft of this paper, I am indebted to Ole Holsti, Irving Janis, Steven Kull, and Richard Ned Lebow. REFERENCES Brecher, M., with B. Geist. 1980. Decisions in Crisis: Israel, 1967 and 1973. Berkeley: University of California Press. Dawisha, K. 1985. The Kremlin and the Prague Spring. Berkeley: University of California Press. DeRivera, J. 1968. The Psychological Dimension of Foreign Policy. Columbus, Ohio: Merrill. Dowty, A. 1984. Middle East Crisis: U.S. Decisionmaking in 1958, 1970, and 1973. Berkeley: University of California Press. Fenno, R. F. 1959. The President's Cabinet. Cambridge, Mass.: Harvard University Press. George, A. L. 1974. Adaptation to stress in political decision making: the individual, small group, and organizational contexts. Pp. 176-245 in Coping and Adaptation, G. V. Coelho, D. A. Hamburg, and J. E. Adams, eds. New York: Basic Books. George, A. L. 1980. Presidential Decisionmaking in Foreign Policy: The Effective Use of Information and Advice. Boulder, Colo.: Westview Press. George, A. L. 1984. Crisis Management: The Interaction of Political and Military Con- siderations. Survival XXVI (5):200-234.

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Written by world-renowned scientists, this volume portrays the possible direct and indirect devastation of human health from a nuclear attack. The most comprehensive work yet produced on this subject, The Medical Implications of Nuclear War includes an overview of the potential environmental and physical effects of nuclear bombardment, describes the problems of choosing who among the injured would get the scarce medical care available, addresses the nuclear arms race from a psychosocial perspective, and reviews the medical needs—in contrast to the medical resources likely to be available—after a nuclear attack. "It should serve as the definitive statement on the consequences of nuclear war." —Arms Control Today

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