A First-Rate Madness

Nassir Ghaemi

The Penguin Press, 349 pages, $32.50

 

Lincoln. Churchill. Franklin Delano Roosevelt. John Fitzgerald Kennedy. Gandhi. Martin Luther King, Jr.

That’s a list of political figures who would rank high on any leadership list, individuals who any government executive would be proud to have served because they shaped history. But it’s also a list of leaders who psychiatry professor Nassir Ghaemi says were mentally ill and who were successful primarily because they were somewhat mad.

His argument twists our perception of leadership, and may give you cause to re-evaluate the less well-known, but perhaps equally insane leaders you have worked for.

We believe that sanity produces good results from leaders, and insanity is a problem. But in his new book, A First-Rate Madness, Ghaemi argues that’s not always the case.

He presents an inverse law of sanity: in times of crisis, we are better led by mentally ill leaders than by mentally normal ones. In times of non-crisis, however, mentally ill leaders will get us in trouble, and mentally stable leaders fare better.

His book tends to focus on two mental illnesses, mania and depression, one of which featured in the life of each of the luminaries named at the outset. Four key elements of those illnesses appear to promote crisis leadership: realism, resilience, empathy and creativity. All four elements accompany depression, and two, creativity and resilience, can be found in manic illnesses like schizophrenia and anxiety disorders. “Depression makes leaders more realistic and empathetic, and mania makes them more creative and resilient. Depression can occur by itself, and can provide some of the benefits. When it occurs along with mania – bipolar disorder – even more leadership skills can ensure,” he observes.

He makes his case through historical examples. In the course of his research, he found mental illness was even more influential in historical terms that he had imagined. Several major Civil War leaders were mentally ill or abnormal: Lincoln; William Tecumseh Sherman; Ulysses S. Grant; possibly Stonewall Jackson; and probably Robert E. Lee. All major leaders of the Second World War were mentally ill or abnormal: Churchill, FDR, Hitler, Stalin, and Mussolini. Two key figures of the 1960s were also mentally abnormal, Kennedy and Martin Luther King.

“I believe these examples are more than coincidence, and more than a historical oddity. They suggest a relatively consistent pattern that, if true, has been largely ignored by historians and the public, but that may have in fact shaped the second half of the 20th century more than any other single force. Once we start to see history through this lens, the reach and impact of madness and leadership becomes hard to deny,” he declares.

That’s a sweeping, counter-intuitive claim, and the first instinct is to dismiss him as just wildly maligning leaders with his labels of mental illness. But he is actually quite rigorous in the book, trying as best as he can through the historical record to diagnose the leaders by the same standards modern-day psychiatrists use with their clients. He studies symptoms, family history and genetics, course of illness, and treatment, often digging out telling factors that biographers ignored.

Many of them were depressives, or manic-depressives. “Our greatest leaders toil in sadness when society is happy, seeking help from friends and family and doctors. Sometimes they’re up, sometimes they’re down, but they’re never quite well. Yet when calamity occurs, if they are in a position to act, they can lift up the rest of us; they can give us the courage we may have temporarily lost, the fortitude that steadies us. Their weakness is, in short, the secret of their strength,” he says.

Exhibit 1 is Winston Churchill, who Ghaemi diagnoses as meeting the current official definition of bipolar disorder, type II (hypomania alternating with severe depression). Churchill was not particularly influential in the 1920s and 1930s, in the relative calm between the wars. He was isolated from power, and depressed, considering suicide. But he was realistic about the threat Adolph Hitler posed, a realism that came, Ghaemi argues, directly out of his depression. Neville Chamberlain, the prime minister before the country lurched to Churchill, on the other hand, was mentally healthy and totally unrealistic about the danger that Hitler posed.

Churchill’s depression also toughened him up for the bleak days his country would face. “Churchill never surrendered to the black dog that gnawed at him from the inside. Having survived this far, he didn’t intend to surrender to other dogs, whether Hitler or Mussolini. He had courage beyond reason, as [psychiatrist Anthony] Storr put it, because he had faced death many time before 1940, and not only during pitched battles fought in exotic lands, but within his daily life,” Ghaemi notes.

Abraham Lincoln suffered from severe depression, probably manic-depressive illness as was common in his relatives. “Most of the time, Lincoln was a highly depressed, even suicidal man. Yet his depression conferred upon him, I believe, realism and empathy that helped make him a superb crisis leader,” writes Ghaemi. The empathy initially allowed him politically to understand those who insisted on maintaining slavery and tempered his instinct for change. Eventually, however, that realism and his empathy for the slaves led him into the Civil War.

But Ghaemi stresses that depression need not be equated just with successful wartime leaders. Ghandi and King are famed exponents of non-violence, and he contends it was their depressive realism that led them in that direction.

Franklin Delano Roosevelt and John F. Kennedy were both hyperthymic personalities, displaying unusual energy and resilience. Both are known now for their extra-marital affairs, a sexual expression of their ever-present energy. Roosevelt dominated conversations with an unusual degree of loquaciousness and intellectual curiosity. He seemed addicted to press conferences, unlike modern-day leaders. “Roosevelt was a whirlwind of a leader, an entrepreneurial leader, always thinking ahead. (After the first wave of New Deal laws, Vice-President James Garner advised the impatient leader, ‘Mr. President, you know you’ve got to let the cattle graze.’) He would have never made a good corporate boss, nor would he have left the country alone in good times, as Coolidge did. Roosevelt was too unhealthy to be a good leader in normal times, but in abnormal times he was just right,” Ghaemi writes.

Kennedy struggled early in his presidency, a period of normalcy. But in the Cuban Missile Crisis and the tumult of the civil rights movement, he excelled. Like his father, Joseph Kennedy, he was a hyperthymic success in the right conditions.

Both JFK and FDR also overcame physical disabilities in part through the resilience their mental illness gave them. FDR suffered from polio and was the president in a wheel chair. Kennedy suffered from a bad back, was nearly killed in a plane crash and when his PT boat was sunk in the Pacific, and had Addison’s disease. Indeed, a year into Kennedy’s term as president, his father remarked on his son’s luck and resilience: “I know nothing can happen to him. I tell you, something’s watching out for him. I’ve stood by his deathbed four times. Each time I said goodbye to him, and he always came back. In that respect he is like FDR. Because FDR went to the edge, and he came back too. And afterwards he was unique. It’s the same thing with Jack. You can’t put your finger on it, but there’s that difference. When you’ve been through something like that back, and the Pacific, what can hurt you?”

What about Richard Nixon? No doubt you have been wonde