FIRST RATE MADNESS: LINK BETWEEN MENTAL ILLNESS AND CRISIS LEADERSHIP

A Book Review by Fred Vergara on…

A FIRST RATE MADNESS:

Uncovering the Links Between Leadership and Mental Illness

By Nassir Ghaemi (Penguin Press: New York, 2011)

(I take time off from writing my own thoughts in order to introduce to you this new and fascinating book on leadership.-Fred Vergara)

There is such a thing as an “inverse law of sanity” and great leadership operates this way: “when times are good, when peace reigns, and the ship only needs to sail straight, mentally healthy people function well as our leaders. But when our world is in tumult, in times of great crises, mentally ill leaders function best.”

This is the essential assertion of this book by psychiatrist Nassir Ghaemi. There are four key elements of mental illness (depression and mania) that appear to promote crisis leadership. They are: realism, resilience, empathy and creativity. Ghaemi theorized that “depression makes leaders more realistic and empathic.”

Some well-known and effective he mentioned a having some form of mental illness, include General William Sherman of the Civil War era; Ted Turner of the cable media greats; Winston Churchill of World War II era; Abraham Lincoln, the acknowledged father of the American nation; Mahatma Gandhi, the acknowledged father of modern India; Martin Luther King, Jr. of the American civil rights and John Fitzgerald Kennedy, one of the most globally-admired presidents of the United States. These leaders, Ghaemi claimed, succeeded in their leadership, “not despite of but because of, their madness.”

While these abnormal people succeeded as leaders, there were some normal people who failed in their leadership. He mentioned particularly former President Richard M. Nixon, McClellan, Lord Chamberlain, former President George W. Bush and former British Prime Minister Tony Blair.

Of course, there are also mad leaders who went the extreme way to infamy such as Hitler, Stalin, and Mussolini. These three had severe depressive episodes or egomaniacal behaviors and instead of accentuating the positive side of their mental illness, they veered towards the destructive side. The book also explained the ambiguous effect of the power of drugs. Consider for instance his assertion that John F. Kennedy’s experience with anti-depressant medicines heightened the positive aspect of his mental illness while Hitler’s drugs ironically exacerbated his egomania.The results in their leadership were extremely different.

The author wrote that there are three basic personality traits, namely: dysthymic or introvert; hyperthymic or extrovert; and cyclothymic or in-between, a little of both. That one is mentally-ill does not necessarily mean one is insane, out of touch of reality or psychotic. Most common behavior is not in abnormality of the thinking process but in abnormality of moods. Clinical depression is different from ordinary sadness. “The depressed person is mired in the past; the manic person is obsessed with the future...the depressed takes her life; the manic ruins hers.”

Repeatedly, the author suggests there is a close link between insanity and genius and that the initial stages of depression or mania are sometimes of benefit to leadership in times of crisis. He quoted a German psychiatrist, Ernest Kretschmer who said the best crisis leaders in history were either mentally ill or mentally abnormal and the worst crisis leaders were, ironically, the mentally healthy. “The brilliant enthusiast, the radical fanatic and the prophet are always there, just as the tricksters and criminals are---the air is full of them but they flourish only during crisis. In peacetime, they are our patients; we rule them. In crisis periods, they rule us.”

Science makes probabilities claims; it is not usually about proving that something is always the case, or never the case. Almost all science is about showing a greater probability that something is usually the case. In most scientific matter, especially in medicine and disease, no single exception is a disproof. The preponderance of evidence represents scientific knowledge.

“We will see that our greatest crisis leaders thrived in sadness. When society is happy, they are there seeking help from friends, family and doctors. Sometimes they’re up; sometimes they’re down, but never quite well. Yet when calamity occurs, they are in a position to act, they can lift up the rest of us, they can give us the courage we may have lost temporarily, the fortitude that steadies us. Their weakness is, in short, the secret of their strength.”

Psychologist Jamison put it this way:”in times of adversity, inspired leadership offers us energy, a hope where little or none exist, a belief in the future to those who have lost it, a unifying spirit to a splintered people.” The reason for this is that people who had suffered some form or depression or manic have a better sense of reality, more empathetic and more resilient than those who had none.  The experience of suffering makes one become more realistic about the world. For the lucky, suffering is less frequent, less severe, and delayed until it can be avoided.  For the unlucky, who early in life endure hardship and tragedies, or the challenge of mental illness, seem to become, not infrequently, a greatest leader.

The author also differentiated three kinds of empathy. Cognitive empathy means thinking another’s thoughts; affective empathy is feeling what others feel; and motor empathy means moving the way another moves. The ultimate empathy is called “pseudocyesis.” For example, a husband who gets morning sickness just like his pregnant wife; his stomach gets bloated like that of his wife; he feels pain and contraction during her wife's birth pangs. This is called pseudocyesis- false pregnancy, the ultimate empathy.

The author spared no great leaders in his list of mild mentally-ill persons. Of Martin Luther King, Jr. he quoted the Rev. Joseph Lowery who said, “To achieve social change, you have to be a little crazy. All leaders of the civil rights revolution were a little crazy, including MLK.”

The book is so fascinating that I read it in one setting right inside the bookstore that I did not have to buy it (sorry Barnes & Noble---but I bought other books too). While reading the book, I remember many years ago when we were moving house in Manila. My brother-in-law who was then president of the Philippine Psychiatrists Association engaged one of his mental patients to drive a borrowed garbage truck to assist us in moving furniture. I was amazed at his driving skill, maneuvering the truck even in a very narrow gate but I could not help but be anxious knowing he was a mental patient . When I expressed my concern, my brother-in-law said, “Don’t worry, he is in his lucid moment.”

A moment of madness, can be a moment of greatness? Read this book to find out more.