“A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness,” by Nassir Ghaemi

Name Here the rest of the author byline intro goes here.

If Nassir Ghaemi is right, the history we learned in school is, indeed, bunk. Lincoln freed the slaves because he was depressed, and Sherman marched on Georgia because he was manic. In World War II, Roosevelt and Churchill were mentally ill, while most Nazi leaders were “completely normal, even commendably well-adjusted.” And the Kennedy presidency was mainly a matter of pharmacology. A bad drug regime produced the Bay of Pigs; a good one led Kennedy to civil rights and success in the Cuban Missile Crisis.

Ghaemi is a practitioner of what he calls “psychological history, an attempt to apply our most scientific current standards in psychology and psychiatry to the study of historical leaders.” He is highly qualified for one half of this project. A psychiatry professor and head of the Mood Disorders Program at Tufts Medical Center, Ghaemi writes with clarity and insight about mental illness. His book is a readable layman’s guide to depression, bipolar disorder and other ills, with colorful case histories and well-chosen quotes. “I have taken more out of alcohol,” Churchill said of his self-treatment for the “Black Dog” of depression, “than alcohol has taken out of me.”

(The Penguin Press/The Penguin Press) - ‘A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness’ by Nassir Ghaemi

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Ghaemi also poses a provocative thesis. “In times of crisis, we are better off being led by mentally ill leaders than by mentally normal ones.” Why? Because depression and mania engender four qualities that are essential in a crisis: “realism, resilience, empathy, and creativity.” Normal leaders are well-suited to normal times, but when the going gets tough, it’s the abnormal you want at the helm.

Ghaemi illustrates his thesis with brief profiles of eight extraordinary men: Abraham Lincoln, William Tecumseh Sherman, Winston Churchill, Mahatma Gandhi, Martin Luther King, Franklin Roosevelt, John F. Kennedy, and, rather bizarrely, Ted Turner. He then selects a control group of “normal” leaders, such as Neville Chamberlain and George W. Bush, whom he judges to have been duds in times of crisis. As a Psych 101 experiment, Ghaemi’s book deserves high marks for original thinking. On the evidence, however, it flunks.

The title, “A First-Rate Madness,” and Ghaemi’s bold thesis prepare the reader for a treatise on mad genius. But the only figure that seems to truly fit this description is Sherman. (Ghaemi writes that a biography he read of the general “launched me on this project.”) Sherman appears to have been a textbook manic-depressive, which Ghaemi claims was the source of his dogged and innovative use of “total war” against the civilian South. Ghaemi also presents a plausible portrait of Churchill as a severely depressed man whose realism and resilience helped steel him in fighting Nazism.

But in neither case does Ghaemi demonstrate a clear link between illness and success. And those are the book’s best examples. In others, he stretches his thesis to include men he terms “hyperthymic,” or mildly manic. This condition is characterized, he writes, by “high energy, elevated libido, workaholism, sense of humor, risk-taking, extroversion, sociability, marked ambition.” By that definition, a high percentage of the population suffers from “First-Rate Madness,” including much of Washington. Yet few Americans would suggest we’re in an era of great leadership.

In any event, Ghaemi’s diagnosis of mild mental illness in FDR and JFK is unconvincing. Seeking genetic evidence, he writes that FDR’s fifth cousin, Teddy Roosevelt, was “probably manic-depressive” and that “closer relations also displayed unusual temperaments.” His analysis of Kennedy is reductive in the extreme. Did JFK really grow in office because doctors tweaked his drugs, as Ghaemi suggests, or because he learned from his mistakes and listened to better advice?

Occasionally, Ghaemi acknowledges the highly speculative nature of his enterprise. He notes that “the line between mental health and mental illness is hardly sharp” and that his inferences linking depression and mania to great leadership “cannot be directly proven.” He also hedges his bets with endless qualifiers. A single paragraph on Adolf Hitler’s mental state includes these caveats: “probably,” “might have,” “seems more likely,” “apparently” (twice), “may have” (four times), “there is some evidence,” “possible” and “probable.” By the end of this passage, the reader can’t help concluding that Ghaemi is fishing in very murky waters.

Yet he repeatedly intersperses this cautious analysis with sound bites devoid of nuance or doubt. “Roosevelt was too unhealthy to be a good leader in normal times; but in abnormal times he was just right.” Civil rights “was a dream conjured up by a depressed leader [King], and realized by a manic one [Kennedy].” The doctor who treated Hitler with an array of stimulants “lit a fuse that exploded the entire world.” Ghaemi seems close to suggesting that methamphetamine, more than “Mein Kampf,” explains Stalingrad and Auschwitz.

His treatment of “homoclites,” the clumsy phrase he uses for leaders he judges mentally healthy, is just as bewildering. Richard Nixon, we’re told, was “rather normal,” unlike Kennedy. “Hence the failures of the first and the resilient successes of the second.” George W. Bush was a blandly accomplished man before becoming president, even a decent student (“a C at Yale is no mean feat”) whose alcoholism “was mild and easily solved.” Hence his inability to deal with the crises post-9/11. Nazi leaders were shown in psychological tests to possess “hardly any antisocial personality traits.” Genocidal, yes, but not mentally ill. Unlike Gandhi and King, whose depression was the wellspring of their success as leaders of nonviolent protest.

In the conclusion of this repetitive book, Ghaemi argues that his thesis “runs counter to a deep cultural stigma accompanying mental illness.” In this he is certainly right. Unfortunately, by shrinking history to a series of mood disorders, “A First-Rate Madness” runs counter to another deep stigma — against balderdash.

Tony Horwitz is the author of the upcoming “Midnight Rising: John Brown and the Raid that Sparked the Civil War.“

A FIRST-RATE MADNESS

Uncovering the Links Between Leadership and Mental Illness

By Nassir Ghaemi

Penguin Press. 340 pp. $27.95

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