Psychology/Psychiatry

Mad Enough to Lead

The insanity of politicians and the politics of insanity

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A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness, by Nassir Ghaemi, Penguin Press, 352 pages, $27.95

The Psychopath Test: A Journey Through the Madness Industry, by Jon Ronson, Riverhead Books, 272 pages, $25.95

Close followers of politics, and perhaps of the current election cycle in particular, must occasionally entertain the notion that a commitment to life in the political realm requires some degree of madness. The title of A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness offers a fleeting hope that author Nassir Ghaemi, a Harvard-trained psychiatrist, will explore that theme. Sadly, he passes up the opportunity. 

Instead Ghaemi cooks up a thesis that is deceptively simple and semi-convincing: Not only did some leaders suffer from mental illness, but mental illness helped them perform well during crises. Balancing this optimistic take on the political uses of insanity is a new book by British journalist Jon Ronson, The Psychopath Test: A Journey Through the Madness Industry, which takes more seriously the dark side of mental illness among powerful men.

A sane president is fine when times are easy, Ghaemi posits, but when the South is seceding or Hitler is on the prowl, you need a Gen. William Tecumseh Sherman, not a Gen. George McClellan; a Winston Churchill, not a Neville Chamberlain. 

Sherman was a disaster at business and pre-war life, Ghaemi writes, while nearly everything came easy to McClellan. But the manic daring of Sherman and his total-war tactics against the South, as opposed to McClellan's stale Napoleonic maneuvers, were what the North needed to win. By 1938 Churchill was allegedly past his prime and Chamberlain was well established as a respected politician, but it was the moody, manic Churchill who saved the world by recognizing and confronting Hitler's monstrosity. 

The key to these successes is supposedly a stew of qualities that often overlap with the symptoms of mental illness: empathy, creativity, and the stark realism associated with depression. Hitler, unsurprisingly, had a bit too much craziness to be useful and then turned dangerously unhinged. Intriguingly, Ghaemi hints that the 1930s Hitler, though cruel and twisted, might not have become the world destroyer of the '40s without massive doses of methamphetamine administered over several years by his doctor, which most likely greatly aggravated his rage, paranoia, and impulsiveness. 

Delving into the minds of so-called great men is nothing new. Woodrow Wilson was once the subject of an absurd book-length analysis by Sigmund Freud. Psychoanalyzing Richard Nixon as his presidency disintegrated was a popular journalistic pastime of the early 1970s. But Ghaemi scoffs at this kind of "fruitless speculation about the early childhood traumas of historical figures." Freudian psychoanalysis has been put in its proper place, and "the new psychiatry begins where modern medicine began, with the search for objective ways to diagnose illness." 

Ghaemi insists that his diagnostic techniques are completely different from Freud's and therefore more reliable for analyzing the mental states of distant figures. Even posthumously you can discover symptoms, genetics (via family histories of mental illness), course of illness (childhood suicide attempts, manic or depressive episodes, etc.), and evidence that the person sought treatment for his illness. 

Ghaemi is fitfully convincing about his subjects; certainly it's plausible that Sherman, Churchill, Hitler, Abraham Lincoln, Mohandas K. Gandhi, Franklin D. Roosevelt, John F. Kennedy, and Martin Luther King Jr. were all slightly to extremely abnormal in temperament. Churchill, Gandhi, and King had depressive episodes. Lincoln was known to be morose much of the time. Sherman, probably bipolar, wrote letters to his wife in which he related his difficulty in recovering from what sounds like a nervous breakdown. 

Ghaemi begins to stretch his premise thin, however, when he gets to two of America's most loved presidents, FDR and JFK. Both of them were described as ebullient, clever, extroverted, and frequently manic in a restrained way—what psychiatrists call a "hyperthymic personality." But Ghaemi's fawning portrait of FDR exposes the author's bias toward historical narrative centered around great men. 

Undeniably impressive in efforts at overcoming his polio-induced paralysis, Ghaemi's FDR also sounds like a delightful dinner companion who leveraged hyperthymia into grand programs such as the New Deal. Ghaemi praises Roosevelt for taking a "non-ideological approach" to Social Security and, while acknowledging that the president's view of government power "remains controversial," reports that FDR "wasn't worried.…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…achieved astounding success." 

Almost all of World War II is given the same breezy treatment. Ghaemi takes it on faith that readers share his awe of FDR's record.

It's fascinating to mine the motivations of historical figures, but "great leaders," and particularly "great presidents," do not fit neatly into categories, no matter how highly they poll. Ghaemi's assessment of FDR as a "successful crisis leader" is not exactly an objective summary of the Squire of Hyde Park's presidency; he intervened dramatically in the U.S. economy during a long period of depression and imprisoned 100,000 American citizens and legal residents without charge, among other questionable decisions. Sherman's legacy is similarly ambiguous; he brutalized the South, even if it did help win the war. 

If Ghaemi had acknowledged that he was just tying together important figures who may have been mentally ill, or picking his favorite historical characters to create a kind of collage of batty greatness, that would be one thing. But to deem them all successful simply because they are well-remembered and may have been mentally ill indicates an overplayed hand. Mental illness "may have in fact shaped the second half of the twentieth century more than any other single force," Ghaemi grandly claims, but he never really supports that thesis.

Ghaemi's secondary agenda is to describe the failings of those people he judges "too sane." He argues that politicians who are so-called homoclites are, like most of humanity, vaguely conformist, moderately ambitious, and too rigid and uncreative in crisis situations. His chief examples for this are Tony Blair, George W. Bush, and Richard Nixon. 

The view of Nixon as dangerously sane will come as a surprise to an entire generation of Nixonologists. Ghaemi insists that Tricky Dick's notoriously erratic behavior was simply a reaction to the stress of his unprecedented situation. Perhaps, but ejecting Nixon from the ranks of the mad seems like a transparent attempt to prop up the theory that a little mental illness can be a good thing. 

Other noncrazies discussed by Ghaemi include the "relatively successful" Ronald Reagan and Dwight Eisenhower. Since the former "never faced a Cuban missile crisis" during his Cold War dealings and the latter mostly "avoided conflict" on civil rights, their mettle was never truly tested and their sanity didn't hinder their decision-making. 

Ghaemi ends his book with a plea for tolerance of mental illness, particularly among our leaders. "We make a mistake…when we choose leaders like us," he argues. "Can we applaud passion, embrace anxiety, accept irritability, appreciate risk-taking, even prefer depression? When we have such presidents—the charismatic, emotional ones, like Bill Clinton— we might have to accept some vices as the price of their psychological talents."

Jon Ronson's The Psychopath Test: A Journey Through the Madness Industry offers a darker, twisted version of Ghaemi's thesis. Instead of asking whether just the right amount of creativity or empathy-enhancing mental illness can make a leader "great," Ronson wonders if a lack of empathy coupled with a sense of heightened self-importance is what delivers success in business and politics. 

Psychopathy is not quite the same as mental illness, Ronson and the experts in his book note, because it does not involve delusions. It is a different way of thinking altogether, almost like being an extraterrestrial. Ronson's notion that psychopathy—which the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) calls "antisocial personality disorder"—leads to success is backed by some mental health specialists, including Harvard psychologist Martha Stout, author of The Sociopath Next Door (sociopath and psychopath are interchangeable terms). She tells Ronson these people love power and winning, and "the higher you go up the ladder, the greater number of sociopaths you'll find there."

Ronson's book is not so much a journey through the heart as a meander around the edges of various important mental health questions. Frequently distracted as he practices his endearing brand of navel-gazing, Ronson wonders if his own anxiety and neurosis are signs that he too is mentally ill. But he generally manages to steer back to his chosen mission: administering "the test." 

That would be Canadian psychologist Bob Hare's widely used, 20-question inventory of psychopathic traits such as "glibness, lack of empathy, and grandiose sense of self-worth." Ronson applies the Hare test to random people he encounters, including a cranky bellhop, and sits down to more formally interview half a dozen more potential psychopaths from the world of politics and business. 

Al Dunlap, the ruthless CEO of the Sunbeam Corporation, who thinks of himself as a predator and decorates his home with images and sculptures of big cats and birds of prey, seems a good candidate, but he manages to escape clear categorization as a psychopath because he cried when his dog died and seems to have stayed faithful to his wife. By contrast, Emmanuel "Toto" Constant, the former Haitian death squad leader whom Ronson interviews in prison, fits the profile to a T. Ronson flirts with Hare's theory that capitalism demands a psychopathic disregard for others but thankfully doesn't take it farther than a few pages.

Although he airs some Scientologists' condemnations of psychiatry, Ronson doesn't doubt the existence of mental illness; his own ungovernable neurosis and anxieties are proof enough. He does undermine the notion that mental illness is a black-and-white issue, however, with a disturbing chronicle of misbegotten diagnoses and cures. There are tales of dubious criminal profilers (and other people who sometimes use and misuse the Hare test), people who fake mental illness and easily get committed to institutions, and the alarmingly haphazard way the DSM gets constructed. 

Ronson, like Ghaemi, wants to understand mental illness and how it fits into society. But the psychiatrist thinks he has cracked some master code of history and politics, while the humble journalist reminds us how little we know about the line between sanity and insanity. 

Lucy Steigerwald is an associate editor at reason.