Some Hippocratic doctors regarded sleep as a healthy process, and some as a pathological one; some of them struggled to distinguish between hallucinations and nightmares, and some between deep dreamless sleep and total loss of consciousness. This chapter explores how different treatises from the Hippocratic corpus navigated these ambiguities, how they explained different depth of sleep (i.e. different levels of consciousness), and how such understanding relates to their views on mental capacities (which they subsumed in concepts such as phronesis, sunesis, gnômê, and nous).

A diachronic look at the contrast between mental illness and impaired consciousness among these ancient doctors shows a trend towards a more compartmentalised idea of these conditions, a stronger notion of disease, and a progressive abstract framing of clinical findings into theoretical classificatory models and comprehensive pathophysiological systems.

The possible neural and neurochemical bases of the hubris syndrome are reviewed by considering relevant evidence from behavioural and cognitive neuroscience in relation to biological psychiatry. This multidisciplinary evidence includes studies of brain-damaged patients and functional neuroimaging and identifies the prefrontal cortex as a crucial region of a brain network undertaking decision-making. The prefrontal cortex is also identified as important for the subjective and behavioural expression of relevant personality traits such as narcissism and impulsivity. Factors that adversely affect so-called executive functions of the prefrontal cortex, such as stress, drug abuse and illness, are also taken into account to highlight possible neurochemical and endocrine influences. A novel hypothesis is presented which postulates a key role for the chronic stress of leadership status depleting monoamine neurotransmitters such as serotonin, dopamine and noradrenaline, which interact with pre-existing temperamental traits, to produce dysfunctional modulation of decision-making circuits controlled by the ventromedial prefrontal cortex

This chapter focuses on Alcibiades’ love–hate relationship with the people of Athens to explore the notion of hybris in the context of leadership. Drawing on the social identity theory of leadership, I argue that the Athenians’ ambivalent attitude towards Alcibiades was a result of his complex interaction with two central aspects of Athenian social identity. Insofar as the Athenians perceived themselves as an imperialist and aristocratic city, Alcibiades was a ‘prototypical’ Athenian in that he embodied and articulated the most extreme form of Athenian imperialism. Insofar as the Athenians perceived themselves as ‘middling’ citizens, however, Alcibiades’ private and public conduct (couched by Thucydides in the language of transgression and hybris) was an affront to the dominant egalitarian political ethos. The analysis of Alcibiades’ mutable relationship with the Athenian people highlights the ways in which a leader’s hybris can manifest itself and how it can impact negatively on the leadership process.

Aristotle defines hybris as a way of mistreating (dishonouring) others. But he also emphasises its psychology, in ways that chime very well with the understanding of the concept in earlier literary sources. As well as indicating a failure to show other people the respect they deserve, hybris is a way of thinking too much of oneself. This affects one’s estimation of the role that luck plays in all human endeavour: the classic Aristotelian case is that of the rich, ‘lucky fools’ who think that their material good fortune is a sign that they excel in all respects; but ancient hybristai in general tend to develop the belief that they are invulnerable to the vagaries of fortune. In this way, hybris regularly entails a failure to deal adequately with risk. At the same time, it bears a relation to the myth of meritocracy, by which the fortunate convince themselves that their success is deserved.

Does power trigger hubris? We consider the effects of having power and the role of dispositions of power-holders on hubris and self-serving behaviour. Drawing on field and experimental research, we demonstrate that having power biases people’s self-concept in a hubristic manner. Power elevates confidence in oneself, one’s perceived competence and heightens self-esteem. Consequently, people in power communicate in a decisive and assertive manner, and so they are influential and have advantages in negotiations. Many feel entitled, take less advice from others, and neglect others’ perspectives. Crucially, the ways power affects people depends on power-holders’ dispositions and goals. People with dominant and hubristic inclinations are more likely to strive for, and reach positions of power. Such self-selection processes enable bad apples to emerge at the top, exuberating the dark side of hubristic behaviour often seen in the high echelons.

This introductory chapter presents and contextualises the main sources under study, and addresses the problems of a definition of consciousness. Given the vagueness of the notion, a working definition is proposed, which is based on cognitive model that uses three prototypical clinical presentations of impaired consciousness: delirium, sleep and fainting.

This chapter presents sleep within a system of opposing tensions (consciousness-unconsciousness, health-disease), and in the midst of extra biological debates, particularly anthropological and sociological. Such tensions and debates illuminate how understanding sleep can be useful to apprehend ancient doctors’ ideas about the mental capacities that are compromised in impaired consciousness.