Mental Health and Leadership – A Sampling of Perspectives
"What Befits a Leader in Hard Times? An Intimate Knowledge
of Insanity"
The premise of Dr. Nassir Ghaemi’s book about leadership
and mental illness is simple. It need not be reiterated as frequently as Dr.
Ghaemi repeats it. But he begins A First-Rate Madness by writing, “This book
argues that in at least one vitally important circumstance insanity produces
good results and sanity is a problem.” To put it only a shade differently:
“When our world is in tumult, mentally ill leaders function best.” Or: “In the
storm of crisis, complete sanity can steer us astray, while some insanity
brings us to port.”
A First-Rate Madness hammers hard to make its one big
point. Sometimes Dr. Ghaemi uses textbook-style italics: “The best crisis
leaders are either mentally ill or mentally abnormal; the worst crisis leaders
are mentally healthy.” At other times he captures the textbook experience via
pedantic tone. “What made Churchill see the truth where Chamberlain saw only
illusion?” he asks rhetorically. “A key difference was that Chamberlain was
mentally healthy (which we’ll discuss more in Chapter 14), while Churchill was
clearly not.”
Dr. Ghaemi, director of the Mood Disorders Program at
Tufts Medical Center in Boston, also favors an overeager, textbook-type
weakness for generalizations that are glib but easy to remember. “Gandhi was
depressed,” he writes at one such moment. “India’s populace was normal. That
distinction may explain it all.” And he does his utmost to provoke controversy,
as when he gives President John F. Kennedy “an unlikely bedfellow” in Adolf
Hitler.
In articulating the flip side of a premise that is
essentially flattering to the gloomy and even the unhinged, Dr. Ghaemi
demonstrates remarkable powers of condescension toward his designated dullards.
Dismissing the part of Tony Blair’s memoir that deals with 9/11, Dr. Ghaemi
writes: “To his credit, Blair maintains a somewhat open mind.” Writing about
President George W. Bush, his thinking is similarly patronizing and also vague.
“Bush’s rise was not easy, but it was not very hard either,” he notes.
Dr. Ghaemi does not intend this as an addition to the
much-debunked field of psychohistory; rather, he sees it as something more
sophisticated. He covers a broad swath of important-sounding material and uses
a greatest-hits lineup of famous leaders, affecting a therapist’s intimacy with
them all. He arranges them more or less chronologically, although an early
section on Gen. William Tecumseh Sherman, who fulfilled Dr. Ghaemi’s criteria
for interesting mental aberration by burning Atlanta, somehow leads to a
passage on Ted Turner, who started CNN there.
Sourcing is a serious problem throughout A First-Rate
Madness. Sometimes he delves into psychiatric records. But he also relies on
Jane Fonda’s memoir for information about Mr. Turner’s manic sexual excesses
and on secondary sources, like Chris Matthews’s “Kennedy and Nixon,” for
anecdotal evidence. The endnotes to A First-Rate Madness can be downright
maddening.
In discussing Kennedy’s dangerous, potentially
mind-altering Addison’s disease, Dr. Ghaemi refers to an old movie (presumably
Nicholas Ray’s Bigger Than Life) in which a patient, treated with cortisone
as Kennedy was, becomes psychotic and commits murder. He reveals the name of
the Kennedy biography from which this anecdote comes but not the name of the
movie.
A First-Rate Madness moves from big target to big
target at a fast, perfunctory clip. The section on Lincoln demonstrates the
book’s method: Look for family history of mental illness. Look for suicide
attempts or other evidence of despondency. Look for manic episodes as well, and
then explore the implications of any medicines that the subject may have been
given. (For Lincoln treatment may have involved cold showers, bleeding and
mercury tablets.)
Then, depending on the degree of sanity on display,
either conclude that the man rose above tremendous obstacles to become a great
leader or was too ordinary to be anything but flummoxed by his life’s
challenges. All the book’s subjects are men.
To read the rest of this book review, please click on thisurlink
"We Need A Bipolar President"
In recent months, discussions about the boom and bust
cycles of our economy going back to the Great Depression have been the focus of
many news stories. During boom cycles, too many of us experience periods of
inflated feelings of power or delusions of grandeur, characterized by excessive
risk taking and out of control spending. During bust cycles, many of us
experience periods of indecisiveness, black and white thinking, loss of energy
and fatigue, even feelings of worthlessness and suicidal thoughts. These
reactions are classic symptoms of bipolar disorder.
Companies can and do prosper during times of economic
turmoil. What do GE, Disney, HP, Microsoft, and Apple have in common? They were
all startups during steep declines in the U.S. economy. GE started during the
panic of 1873, Disney started during the recession of 1923-24, HP began during
the Great Depression, and Bill Gates and Paul Allen founded Microsoft during
the recession of 1975. Even today, while the economy is in the worst down
period since the Great Depression, Apple is thriving. All these companies
realized that they had an advantage by adopting a different mindset, a
different way of seeing the crisis. Instead of succumbing to the situation,
they saw it as an opportunity to innovate and grow.
Those of us who have changed our mental condition from
bipolar disorder to bipolar IN order have something important to share. We have
found strength in what was at one time a debilitating weakness. We have learned
how to function in all states, including the extremes of mania and depression.
The insights we have and the tools that we use can help our companies to
function better in both boom and bust times. We can inspire everyone to move
forward instead of being crippled by fear and doubt.
It is times like these that call for a different kind of
leader. We need someone who understands bipolar and can inspire us all. We need
a bipolar president.
Dr. Nassir Ghaemi is 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 serves on the faculty of Harvard
University’s Medical School, and has degrees in history, philosophy and public
health. His new book comes to the same conclusion.
In A First-Rate Madness: Uncovering the Links Between
Leadership and Mental Illness, Dr. Ghaemi argues that the very qualities
associated with mood disorders have produced brilliant leadership under the
toughest circumstances. He focuses on those leading during very turbulent
periods and he identifies four key elements essential to crisis leadership:
realism, empathy, creativity, and resilience. All, he posits, can be directly
enhanced by mental illness: empathy and realism by depression, creativity by
mania, and resilience by both.
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"Winston Churchill and Manic-Depression"
In 2006, a British mental health charity defended a
statue it commissioned of Churchill in a straitjacket, after the statue sparked
a public outcry.
Some people were outraged by the attempt to link Winston
Churchill and manic depression (bipolar disorder). The charity claimed it was
trying to project a more positive image of people with mental illness.
According to a spokesperson:
"The message we want to portray is that it is
possible to recover from mental illness and overcome it and be successful -
because Churchill is an example of someone who was able to do that."
In fact, some believe that it was more complex than that
- that Sir Winston's achievements were because of his bipolar - not in spite of
it. In a sparkling essay in his book Black Dog, Kafka's Mice, and Other
Phenomena of the Human Mind, psychiatrist and historian Anthony Storr wrote:
"Had he been a stable and equable man, he could
never have inspired the nation. In 1940, when all the odds were against
Britain, a leader of sober judgment might well have concluded that we were
finished."
"I don't like standing near the edge of a platform when an express train is passing through. I like to stand right back and if possible get a pillar between me and the train. I don't like to stand by the side of a ship and look down into the water. A second's action would end everything. A few drops of desperation." - Winston Churchill (1874-1965)
Churchill made frequent references to his depression,
which he called his "black dog".
Many believe Sir Winston coined the expression
"black dog" himself, but this expression is actually much older.
Churchill's depressive periods tended to be intense and
prolonged. Sometimes they were connected with traumatic external events such as
his dismissal from the Admiralty after the Dardanelles disaster in WWI. Other
times they could not be atributed to such outside causes, fitting the classic
profile of serious unipolar or bipolar depression. His depressions came and
went throughout his long and remarkable life, and commenced in his youth.
Churchill seemed to be aware that his depression was a
medical condition. In 1911 a friend of Churchill's claimed to have been cured
of depression by a doctor. Churchill wrote about this with some excitement in a
letter to his wife, Clementine:
"I think this man might be useful to me - if my black dog returns. He seems quite away from me now - it is such a relief. All the colours come back into the picture."
However, Churchill was writing at a time before the
development of effective medication, when the main medical approach to mood
disorders was psychoanalytic. Churchill's doctor, Lord Moran, wrote a memoir
about his famous patient, emphasizing the black dog - it describes plenty of
symptoms but no treatment. (Although when Churchill was almost 80, Dr Moran did
prescribe some speed to give Sir Winston enough of a boost to make a final
speech in Parliament.)
Today we can only make a retrospective diagnosis linking
Winston Churchill and manic depression if we have evidence of mood swings - not
depression alone. According to Sir Winston's close friend Lord Beaverbrook, the
great man was always either "at the top of the wheel of confidence or at
the bottom of an intense depression." This does sound like a description
of Winston Churchill and manic depression.
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