The thesis is maddeningly simple: the “insane” leaders tend to charge through difficult times better than the “sane” leaders who waffle about and end up thinking that the Sudetenland really is all the Führer wants. Ghaemi contends that Abraham Lincoln and Winston Churchill used their depression to “realistically” lead the country through their respective wars, that Mahatma Gandhi and Dr. Martin Luther King Jr.’s early suicide attempts made them practice “radical empathy”, that J.F.K. was hopped up on steroids and amphetamines to both his detriment (Bay of Pigs) and success (Cuban Missile Crisis), that General Tecumseh Sherman razed Georgia to the ground in a March of Mania, and that Ted Turner is just a crazy son-of-a-gun who can’t stop buying airplanes.
The weaknesses of the book are inherent to the small sample size and the odd source gathering used. Ghaemi hunts for family members who had mental illnesses, looks at substance abuse (but is actually surprisingly picky about this: George Bush Jr.’s DUIs are apparently not a problem because it was “easy” for him to quit), and then retroactively diagnoses his case studies with Creativity if manic, Realism if depressed, Energy if hyperthymic and Empathy if suicidal.
However, despite its frustrating method of cherry-picking historical figures and source material, the reason that A First-Rate Madness is an interesting concept is because of the easy jump it is to make (from personal experience, no less) that there actually might be something to Ghaemi’s observation. Reading about Ghaemi’s definition of what makes one of his case studies “insane” led me to recall a piece in The New York Times by Dr. David Linden “Addictive Personality? You Might be a Leader.” Ghaemi doesn’t go into any sort of biological connection between madness and leadership past family ties, but Linden does.
Linden, a professor of neuroscience at Johns Hopkins University, posits that the urge to find success runs stronger in certain individuals, and that said “addicts” are less likely to enjoy that success. It’s the story of the high school student who studies for hours each night, leads several extracurricular organizations, runs themselves down to the bone in anticipation of getting into the best college, and then, once there, realizes that he will only be happy with an even bigger goal: grad school or a high-paced, neurotransmitter-stimulating job in finance, politics, or business. The similarities to Harvard’s student body and its predilection to produce leaders seems much more clear.
However, such a desire to chase success also ties in with the desire to seek novel sensations and fuel the dopamine motor. Intense exercise, alcohol, fatty foods, sex, and even more oft-lauded ideals such as generosity and learning all seem sinisterly attractive to such individuals. The difference between Linden’s handling of addiction and Ghaemi’s is that Ghaemi believes that there is something inherent in the suffering and tribulation of his leaders that makes them great, whether Linden believes that great leaders succeed in spite of their trials. “The risk-taking, novelty-seeking and obsessive personality traits often found in addicts can be harnessed to make them very effective in the workplace. For many leaders, it’s not the case that they succeed in spite of their addiction; rather, the same brain wiring and chemistry that make them addicts also confer on them behavioral traits that serve them well,” Linden writes.
And thus, there is a confounded claim and variable that Ghaemi dangerously ends the book with, “My claim is that mental illnesses, like depression, do not detract from such abilities, but in fact can enhance them… Quite a paradox it is: being open to some depression may allow us, ultimately, to be less depressed.” Ghaemi confuses the manifestation of negative symptoms as a sort of indicator that a depressed person would be a good leader instead of making clear that a good leader might be more likely to be depressed. In between this sort of glamorization of mental illness, he also says that he realizes that there should be treatment for those who suffer from mental illness, but also that “drugs don’t work,” placing Lithium on the level of Abraham Lincoln’s experience with mercury treatment and bleeding.
Ultimately, A First-Rate Madness is not only an example of pop-neuroscience gone awry, but also a shockingly insidious read that passively asserts that those who suffer from mental illness should harness their depression or mania and turn them into delusions of grandeur. A more in-depth study of the biological mechanisms behind the conditions he so carefully studies might have revealed that supporting what is inherently painful is a tumultuous road to take.