A First-Rate Madness
Nassir Ghaemi
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Buy *A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness* by Nassir Ghaemi online

A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness
Nassir Ghaemi
The Penguin Press
Hardcover
352 pages
August 2011
rated 5 of 5 possible stars

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The estimated 9.1 million U.S. adults suffering from depression and bipolar diseases owe a huge debt of gratitude to Nassir Ghaemi for his book A First-Rate Madness. In this groundbreaking work, Ghaemi has proven that what is overwhelmingly perceived as a debilitating weakness actually contributes to stellar leadership in chaotic times. By examining important leaders’ medical histories, correspondence, biographies and actions, Ghaemi substantiates his claim that afflicted men such as Abraham Lincoln, General William Tecumseh Sherman and Winston Churchill provided creative, effective direction during dangerous times.

Ghaemi pinpoints four traits common to many who have experienced depression and/or mood disorder symptoms: realism, empathy, creativity and resilience. The author connects Columbia University researcher George Bonanno’s use of the term “hardiness” (“being committed to finding a meaningful purpose in life, the belief that one can influence one’s surroundings and the outcome of events, and the belief that one can learn and grow from both positive and negative life experiences”) to the hyperthymic—mildly manic—personalities of beloved politicians like John F. Kennedy and Franklin D. Roosevelt. Indeed, the hyperthymic personality, Ghaemi supports, is often successful because such active minds avoid George W. Bush and Tony Blair’s errors of sticking fast to a decision once made, even when it is proving to be the wrong decision.

Ghaemi also describes how FDR and John F. Kennedy, in particular, developed resilience from their physical and ensuing mental difficulties, and how we all benefitted from their resilience during the Great Depression and the Bay of Pigs. In other words, episodes involving physical pain and mental anguish are not only a struggle to be overcome personally, making most individuals stronger in the process, but depressive episodes can leave leaders with an unmatched resilience, one that will outlast opponents who have typically “normal” mental states. Their struggles, “improved their ability to lead.”

Using the cognitive-behavioral model to view depression, Ghaemi notes: “This theory argues that depressed people aren’t depressed because they distort reality; they’re depressed because they see reality more clearly than other people do.” The perfect example of this seems to be Sherman’s March to the Sea, which effectively broke the morale of the Confederate people; something Sherman recognized had to be done to end the Civil War.

Most who suffer from bipolar disorders are extremely creative, a trait that helps a leader shift beyond traditional tactics. It is not hard to see this characteristic in Ted Turner’s creation of CNN and, subsequently, Headline News. Unfortunately, it also contributed to his unhappiness as a cog in the massive Time Warner Corporation and led to his ultimate resignation from AOL Time Warner.

Even highly effective leaders themselves respect creative greatness, as Ghaemi reports:

“Franklin Roosevelt observed this feature of Churchill’s personality after the landings at Normandy, part of which involved creating artificial harbors made by sinking old ships filled with concrete one on top of the other to break the rough coast. Said FDR, ‘You know, that was Churchill’s idea. Just one of those brilliant ideas that he has. He has a hundred a day and about four of them are good.’”
Mahatma Gandhi, Martin Luther King Jr., Richard M. Nixon and Adolf Hitler are also examined in light of past documents and historical perspectives. The troubled leader Hitler (whose parents were cousins, contributing the same predisposition to mental illness to their son) deviated from a more normal leadership pattern due in part to an excessive use of amphetamines and steroids which no doubt exacerbated his mental illness. (JFK utilized steroids as well to help combat Addison’s disease, but his doctors and advisors wisely reduced dosages while he was President.) Have no doubt, though: Ghaemi is clear that certain types of mental illness are not conducive to constructive leadership—and all types can be escalated by the improper and/or an escalating use of pharmaceuticals. In the case of Nixon, Ghaemi concludes that he was not mentally ill, just suffering from an enormous ego that prevented him from reacting in any sort of positive way to the Watergate fiasco.

Attacking the conventional wisdom that “normal” is always better, Ghaemi reflects on why other politicians and military leaders in addition to Nixon, Bush and Blair, men like General McClellan and Neville Chamberlain, fail to lead effectively during crisis after appearing competent during less challenging times. For some it is a lack of empathy, the ability to view decisions in light of others’ perceptions and feelings. Hurricane Katrina certainly comes to mind. Both Gandhi and King understood its importance and “made empathy the core of their political method… the psychological underpinning of nonviolent resistance.”

For generations, it has been accepted that while “suffering artists” and innovators benefit from bouts of depression and the oft-accompanying mood disorders, individuals in positions of political or military power should be free from mental instability. Ghaemi has hopefully started to smash the stigma that mental illness always has a negative effect on leadership. As the Reverend Martin Luther King observed: “Human salvation lies in the hands of the creatively maladjusted.” The average person doesn’t believe he or she can change age-old problems like discrimination. According to the author, “For abnormal challenges, abnormal leaders are needed.”

Modern medicine has advanced treatment of depression and bipolar illnesses to an amazing degree. Ghaemi scolds readers that: “Mental illness isn’t like being pregnant—you are or you are not—it’s more like hypertension, or diabetes, or heart disease, all of which involve gradations of abnormality….” Lets hope that his readers are listening.

Ghaemi is a doctor, a professor of psychiatry at Tufts University School of Medicine and the director of the Mood Disorders Program at Tufts Medical Center in Boston. He trained in psychiatry at Harvard University’s Medical School, is currently on the faculty there, and also has degrees in history, philosophy and public health.



Originally published on Curled Up With A Good Book at www.curledup.com. © Leslie Raith, 2011

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