After examining the psychological histories of a few living leaders and a whole little power necropolis, Nassir Ghaemi, director of the Mood Disorders Program at Tufts University Medical Center, is ready to proclaim a link between madness and achievement that is usually reserved for poets, not prime ministers: “Depression makes leaders more realistic and empathic, and mania makes them more creative and resilient.” It may be fine to like Ike during periods of smooth sailing, but Lincoln and a little lunacy are the ticket when seas get rough: “For abnormal challenges,” Ghaemi insists, “abnormal leaders are needed.” The text makes only one reference to the current president, warning us that while “ ‘No drama’ Obama might be considered the epitome of mental health,” we must remember that “psychological moderation” is not the prescription for greatness.
Abraham Lincoln’s “depressive episodes” are well known, and their political implications have been the subject of thoughtful extended treatment, most recently by Joshua Wolf Shenk in “Lincoln’s Melancholy.” By contrast, Ghaemi’s assertion that Lincoln’s “depression conferred upon him . . . realism and empathy that helped make him a superb crisis leader” is unaccompanied by the least bit of proof or persuasiveness. The 16th president is on and off the couch in the space of nine pages that whiz by like a single 50-minute session. Ghaemi has to get to two other empathic depressives — Mahatma Gandhi and Martin Luther King — who are out there in his waiting room.
Using the “four indicators” he likes to apply to the dead — the available records of “symptoms, genetics, course of illness and treatment” — he sees Gandhi as having a “dysthymic personality” that involved “chronic mild depression and anxiety.” The Mahatma’s practice of nonviolent resistance may well have derived from his psychology, but Ghaemi tends to misunderstand what he calls Gandhi’s “radical empathy,” seeing it as little more than kind feelings toward his enemies rather than a mental capacity to walk in their shoes. In the case of King, the author observes genuine “mental illness” at work, including clinical depression toward the end of King’s brief life. But Ghaemi’s analysis is not helped by the way one of his chief sources, Dr. Alvin Poussaint, a civil-rights comrade of King’s as well as a professor of psychiatry, doesn’t regard depression as a major factor in King’s behavior. And it is weak indeed to take an offhand remark by the Rev. Joseph Lowery — about how civil-rights protesters, facing huge dangers, needed to be “a little crazy” — and offer it as a piece of medical evidence. One wonders if, in his exploration of empathy, Ghaemi might have done better with less transcendent figures than Gandhi and King. The juicy, earthbound Bill Clinton, with his trademark ability to feel one’s pain, comes immediately to mind, but he scarcely enters the author’s consulting room.
If depression did help Gandhi and King to engage with their visions, Ghaemi believes that Churchill’s experience of the “black dog” taught him “political realism.” Alcoholic and perhaps bipolar, the British prime minister had the churning, multiple moods of the “cyclothymic personality.” Churchill, Ghaemi argues, was “never ‘himself,’ because his ‘self’ kept changing,” in an exhausting series of alternations and adaptations. There was a reason Churchill saw through Hitler after his predecessor failed to. “Chamberlain was mentally healthy,” Ghaemi concludes, “while Churchill was clearly not.”
One problem with “A First-Rate Madness” is the way it seems to indicate that almost any mental illness, within limits, will do the trick. The decidedly undepressed Franklin Roosevelt helped win the same war Churchill was fighting, and he did it, Ghaemi explains, with a non-neurotic but “hyperthymic” personality. He was eager to be liked, loath to be alone and interested in everything; he once put down “None” on a questionnaire that asked for a list of “aversions.” But how much sense does it make to attribute Roosevelt’s flexibility to his “mentally abnormal” condition? More than six decades after his death, a doctor can pronounce him “hyperthymic”; the voters on the scene thought he was tiptop.
Roosevelt’s hypersociability became, in John F. Kennedy’s case, “hypersexuality.” The recklessness displayed by the 35th president was, Ghaemi argues — by toting up plane crashes and drug overdoses and accidents on the ski slopes — a family trait: “There is no Kennedy curse. There is a Kennedy gene — for hyperthymia — that is both a curse and a blessing.” The president misused anabolic steroids as well as amphetamines until a “medical coup d’état,” headed by a White House doctor, George Burkley, and carried out some time before the Cuban missile crisis, got Kennedy on the proper regimen of prescription drugs. The result, Ghaemi believes, paraphrasing Kennedy’s urologist, was “a spectacular psychochemical success.” From it the author seems to derive a kind of contact high, one that sends him on a fanciful flight of alternate history: “The military presence in Vietnam, later disastrous, was a mistake made in 1961, when Kennedy was medically ill and psychiatrically erratic. By 1963, Kennedy expressed reservations about further involvement in that conflict. Had he lived, he probably would not have responded the way Lyndon Johnson did.” Or he would have.
Ghaemi does nothing by halves. Admitting that his next psychological autopsy is a “delicate” matter, he moves on from Kennedy’s case to Hitler’s. “Up to 1937, I think his moderate bipolar disorder influenced his political career for the better — fueling his charisma, resilience and political creativity.” Later, though, Hitler’s personal physician, Theodor Morell, began injecting the Führer with amphetamines, thereby lighting “a fuse that exploded the entire world.” Ghaemi would have rendered a malpractice judgment at Nuremberg.
“A First-Rate Madness” goes most seriously wrong when Ghaemi explores a “corollary” of his main proposition, offering examples of how “mental health can hamper leadership.” Using a term from Roy Grinker’s half-century-old study of the “normal American male,” the author puts George W. Bush, Tony Blair and Richard Nixon (a “healthy failure” who “had his quirks”) into the category of “homoclites,” men better equipped to follow than to lead. Ghaemi even argues that the successes of “levelheaded” Harry Truman don’t refute this part of his thesis, since Truman wasn’t “handling major crises” during what Ghaemi seems to regard as an eight-year cakewalk from Hiroshima through Korea.
By this point, a reader begins to feel that the author is practicing history without a license, a sensation not diminished by the way Ghaemi puts Wendell Willkie on the ballot in 1944 instead of 1940; puts Kennedy there in 1945 instead of 1946; and has a famous 1960 election-night anecdote involving Kennedy and Johnson exactly backward. He says that Nixon was “the first president to invite” Kennedy’s widow and her two children “for a White House visit” — never mind that Johnson can be heard, on recordings of his phone conversations, practically begging Mrs. Kennedy to drop by.
“We are far from accepting severe depression or mania in our leaders,” Ghaemi concedes. “But there is reason for hope.” He points to voters’ willingness to elect Senator Lawton Chiles and Rep. Patrick Kennedy after each of these lawmakers disclosed his mental-health problems and course of treatment. The further electoral leap that Ghaemi prescribes, one that would turn psychological afflictions into positive credentials, remains far off. In the meantime, “A First-Rate Madness” will make a thoughtful present for any politician going through rehab and feeling a little discouraged.
by Thomas Mallon in the New York Times
By Nassir Ghaemi