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MIND Reviews: A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness














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A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness
by Nassir Ghaemi. Penguin Press, 2011

In 1972 Thomas Eagleton was chosen to run as the democratic vice-presidential nominee under George McGovern in the race against Richard Nixon. But it soon emerged that Eagleton suffered from depression and had received shock treatment for it. A scandal erupted, and Eagleton stepped down, forming a cloud that still hovers over politics today.

Psychiatrist Nassir Ghaemi thinks the public is mistaken in wanting leaders who appear sane and mentally healthy. In A First-Rate Madness, he proposes that Eagleton may have actually been the best candidate to deal with a national crisis because of, not in spite of, his depression.

The crux of Ghaemi’s argument is that people who are depressed exhibit what psychologists have dubbed “depressive realism”—an all too accurate view of the world. Since the 1970s, when the concept of depressive realism first surfaced, some studies have suggested that people who are mentally healthy actually have overly optimistic ideas about their place in the world.

Being depressed, on the other hand, can give people keener powers of perception and heightened abilities to assess complex or tumultuous situations. In fact, various studies have shown that being bipolar can make people more creative, resilient and in tune with their environment.

Ghaemi details “case studies” wherein he examines respected political figures—such as Abraham Lincoln, Winston Churchill and John F. Kennedy—who lived with depression or mania, or both, and argues that these qualities enhanced their leadership skills. Conversely, he asserts that leaders considered mentally healthy do well during times of peace and prosperity but falter during crises because they lack the practicality or creative thinking skills that leaders with mental disorders often exhibit. Ghaemi offers an anecdote in support of his point: the sane British prime minister Neville Chamberlain thought Adolf Hitler was someone who could be reasoned with, but Churchill saw from the beginning that the strategy would never work.

On the surface, the theory may seem counterintuitive. But Ghaemi provides exhaustive research and makes a compelling case for his point, which is perhaps best summed up by an aphorism from Martin Luther King, Jr.: “Human salvation lies in the hands of the creatively maladjusted.”


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  1. 1. RHoltslander 10:20 AM 10/14/11

    Unfortunately one of Nassir Ghaemi's premises is in error. He presumes that elections and the electorate are focused on the best leader, as if they could tell. Elections are popularity contests which keep the electorate at a long distance from the candidates. There is almost no way to tell who will be good at these positions so people fall back onto proxies like "don't vote for anyone who has revealed a failing" (perceived or otherwise).

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  2. 2. candide in reply to RHoltslander 11:12 AM 10/14/11

    "Elections are popularity contests which keep the electorate at a long distance from the candidates."

    Maybe they were at one time.
    Elections these days are bought or stolen.

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  3. 3. promytius 11:23 AM 10/14/11

    This articles baffles me - it's hard to even articulate how ridiculous his premise is, on its face. Electorates are not prescient, and "best" is a non-starter in evaluating political office seekers. I would postulate that you HAVE to be insane or at least severely neurotic to run for political office, asthey continually manifest a swatch of other psychological problems, narcissism, delusions, persecution, sexual deviancy, and habitual dishonesty. I'm fairly certain if you asked people on the street how mentally sound their politicians are; well, just try it. We expect it from them. That's why we need to continually vote them out of office. VOTE!

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  4. 4. jgrosay 03:34 PM 10/14/11

    A comedy movie depicts politicians as having most of his time spend in making love with his secretary. Some recent cases of this published in the media corroborate the concept of hypersexual persons in top management positions, but, how true is this ?. Any statistics on the subject ?

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  5. 5. nholt 06:47 AM 10/19/11

    I'm wondering if any of you have actually READ the book. His arguments are quite compelling and well researched. And, no, the premise isn't "ridiculous" on its face, as one commenter has posted. Instead, I think it is extremely counterintuitive. As a journalist who covers leadership issues, I think this book is long overdue and takes a cold, hard look at the phenomenon of depressive realism as it applies to decision making during times of great crisis. It is not a book about the "prescience of the electorate," which I agree is a nonstarter. And I also agree that many, if not most, politicians are severely narcissistic.

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  6. 6. hamidsadeghipour 10:27 AM 10/20/11

    The leadership is a skill. You need to know your world and what is going on. It is like a engineer, you must have enough knowledge to repair a system of your expertise. But the emotional intelligence is another aspect. Anyone can be a consultant but decision making needs a sane person. Of course a correct decision making system is necessary. What make a person quality are his characteristics. It applies to organizations as well.

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  7. 7. jgrosay 02:49 PM 10/20/11

    In the relationship between Chamberlain, and Hitler, and Churchill, some outsiders point that once Chamberlain had a shakehands with Hitler, he was contaminated by his goals. Those not very lovers of Churchill say that Chamberlain was defeated because he was against the strategic bombings on German targets. Most probably, WW I and WW II were the consequences of the too tight anti-german policies of the french Clemenceau, Hitler being an accident of the worst kind that could be expected in the war of France and the UK to elliminate an aggressive and potentially serious economical competitor, Germany, besides their involvement in the promotion of political institutions more favourable to their national interests, and supposedly, also to peace and human rights. Today, the EU is a united market, no conflict in Europe can be expected, and just the UK keeps on being the smart partner, taking advantage of both the EU and their own Commonwealth and Pound protected economies. Who said : Rule Brittania, there's nothing like us ! ?

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