(++++) CRAZED BRILLIANCE?

A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness. By Nassir Ghaemi, M.D. Penguin. $27.95.

     There is nothing new, psychiatrically speaking, in finding a linkage between madness, or at least deep-seated neurosis, and genius: one of Sigmund Freud’s important works was a psychoanalytic biography of Leonardo da Vinci (1910), and Freud’s protégé Marie Bonaparte’s psychoanalytic study of Edgar Allan Poe (1933) remains a classic. But Nassir Ghaemi, psychiatry professor at Tufts University and director of the Mood Disorders Program at Tufts Medical Center, takes matters a step further in A First-Rate Madness, arguing forcefully that it is the mental illnesses of various leaders that made them as successful as they were. That is, depression and mania, in particular, were not burdens to be overcome by such leaders as Abraham Lincoln, Winston Churchill and General William Tecumseh Sherman – instead, they were keys to their abilities to lead successfully.in extremely difficult circumstances.

     This is an intriguing viewpoint, if not a wholly convincing one. Ghaemi argues that four elements crucial to crisis leadership – realism, empathy, creativity and resilience – can be enhanced by certain forms of mental illness. Mania can make someone more creative, for example, or depression can make the person more empathetic. This is arguable – depression tends to lead to a deep inward focus, the opposite of outward-oriented empathy – but it is an idea worth exploring when applied to specific cases. In other words, what psychiatrists would diagnose as mental illness may, in the cases of such people as John F. Kennedy and Mohandas Gandhi, become a foundation for improvements in leadership behavior. The key is that this effect is far from universal: individuals must have particular personality characteristics (which Ghaemi never attempts to codify) in order to benefit from mental illness rather than be severely damaged by it.

     A First-Rate Madness is not easy reading, even when Ghaemi goes out of his way to italicize points he tries especially hard to make: “We come now to the paradox of trauma – its steeling effect. Not only can it make a person psychiatrically ill, but it can make someone psychiatrically healthier. There is post-traumatic growth: trauma itself might not harm some people psychologically at all; it might in fact help them. It is not a matter of getting better despite the trauma, but rather because of it.” Or: “The vaccine metaphor leads to another metaphor (Nietzsche once said that truth is a mobile army of metaphors): immunity.” Enjoyment of the cadences of Ghaemi’s style is a prerequisite for following and taking pleasure in his arguments.

     Ghaemi’s analysis of motivations is strong on the psychological side but tends to be weak on the political one, and is even tinged at times with hero worship: “Franklin Roosevelt wasn’t worried about any accusation, nor even of bringing about piecemeal socialism in the United States. He knew only that people were hurting; he knew what it was like to hurt; and his personality would not allow him to sit still. He tried whatever worked, and with that method he achieved astounding success.” Ghaemi also analyzes Roosevelt’s great World War II adversary, Adolf Hitler, saying that Hitler “most probably [had] bipolar disorder” (other writers have suggested he may have had syphilis). Ghaemi seeks to make a specific, comparative point about Hitler: “Kennedy’s leadership was eventually enhanced by steroids, interacting with his hyperthymic personality; Hitler’s leadership was eventually destroyed by amphetamines interacting with his bipolar disorder.” Like many assertions in A First-Rate Madness, this one is both arguable and fascinating.

     Equally fascinating are Ghaemi’s remarks on “healthy failures,” or “failed homoclite leaders,” as Ghaemi terms them. Mental health can actually hamper leadership, Ghaemi argues, citing George W. Bush, Tony Blair and Richard Nixon as examples (and he admits that identifying Nixon as normal “will not satisfy some readers”). Anticipating argument on this point, Ghaemi writes, “I realize that some readers may be thinking of counterexamples: what about Reagan, Eisenhower, Truman? They all seemed levelheaded and relatively successful. I would say they were homoclites, but that their presidential successes did not include handling major crises, like World War II (almost over when Truman took office), or nuclear standoff (Reagan never faced a Cuban Missile Crisis), or the civil rights crisis (Eisenhower briefly intervened in Little Rock, and otherwise avoided conflict).” This counterargument by Ghaemi falls short: Truman, for example, had to decide to use atomic weapons against Japan, fight the Korean War, and fire General Douglas MacArthur. But even when Ghaemi is wrongheaded, he is never less than interesting. And that is the ultimate value of A First-Rate Madness: this is a book for thinkers, written by a thinker, and it will make readers look at forms of mental illness differently than they have in the past – whether or not they ultimately agree with Ghaemi’s arguments and conclusions.