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A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness

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In A First-Rate Madness, Nassir Ghaemi, who runs the Mood Disorders Program at Tufts University Medical Center, draws from the careers and personal plights of such notable leaders as Lincoln, Churchill, Gandhi, Martin Luther King, Jr., JFK, and others from the past two centuries to build an argument that the very qualities that mark those with mood disorders- realism, empathy, resilience, and creativity-also make for the best leaders in times of crisis. By combining analysis of the historical evidence with the latest psychiatric research, Ghaemi demonstrates how he thinks these qualities have produced brilliant leadership under the toughest circumstances.individuals and society at large-however high the price for those who endure these illnesses.

340 pages, Hardcover

First published August 4, 2011

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About the author

S. Nassir Ghaemi

16 books69 followers
Nassir Ghaemi MD MPH is an academic psychiatrist specializing in mood illnesses, depression and bipolar illness, and Editor of a monthly newsletter, The Psychiatry Letter (www.psychiatryletter.org).

He is Professor of Psychiatry at Tufts Medical Center in Boston, where he directs the Mood Disorders Program. He is a also a Clinical Lecturer at Harvard Medical School, and teaches at the Cambridge Health Alliance.

In the past, he trained and worked mostly in the Boston area, mainly in Harvard-affiliated hospitals (McLean Hospital, Massachusetts General Hospital, and Cambridge Hospital). He has also worked at George Washington University, and Emory University. His medical degree is from the Medical College of Virginia/​Virginia Commonwealth University.

His clinical work and research has focused on depression and manic-depressive illness. In this work, he has published over 200 scientific articles, over 50 scientific book chapters, and he has written or edited over half a dozen books. He is an Associate Editor of Acta Psychiatrica Scandinavica, and is a Distinguished Fellow of the American Psychiatric Association.

After his medical training, he obtained an MA in philosophy from Tufts University in 2001, and a MPH from the Harvard School of Public Health in 2004.

Born in Tehran, Iran, he immigrated to the US at the age of 5 with his family and was raised in McLean, Virginia by his father Kamal Ghaemi MD, a neurosurgeon and neurologist, and his mother Guity Kamali Ghaemi, an art historian. A graduate of McLean High School (1984), he received a BA in history from George Mason University (Fairfax, Virginia, 1986).

He is an active writer, and besides his books, newsletter, and scientific articles, he writes a column for Medscape.

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Displaying 1 - 30 of 599 reviews
Profile Image for Nancy.
1,105 reviews408 followers
August 23, 2011
Who writes history? Those who control the media and the winners of any conflict. This is a summary of some of history's greatest and worst leaders. It reads much like a dissertation only without statistical data to support the hypothesis but plenty of anecdotal which is soft data. The author asserts that the best leaders in war and other stress, were on the bipolar spectrum. The worst leaders under stress were mentally stable.

Many of the examples used are self-proclaimed sufferers of depression or other mood disorder. Others suffered from a physical malady which, when treated medically, led to an unstable mood. Or a sexually transmitted disease which produced an atypical mood. At any rate, the author suggests that a depressed person is more likely to exhibit realism, a manic person has enhanced creativity and a depressed person feels more empathy. I agree to some degree that this is true, only I wouldn't put these people directly on the mental illness scale. An awake person expresses greater creativity while a depressed poet produces depressing poetry which is not in a manic stage. A person who has experienced life, not necessarily depression, might already know they don't control the world but how they react to circumstances.

A few months ago I read "The Psychopath Test" which empowered those trained in this checklist to diagnose a psychopath. In short order, the checklist qualified most of the population as exhibiting psychopathic personalities. As a graduate student in psychology, I read my new DSM III-R and diagnosed myself with no less than 58 psychological disorders. Once informed of the uses of the DSM and realizing it is only the extremes that interfere with regular interactions and work, my list dropped to only two. One when I wasn't PMS-ing.

It is much easier to find episodic personality traits and pigeon-hole a historical leader into a mental illness, especially if that person is dead and unable to refute the diagnosis. It is also known that psychiatry and psychology is a soft science. Not that I don't respect the field because I do. On the other hand, the new diagnosis is Pervasive Developmental Disorder or the Autism Spectrum. Now all the quirky kids who have a less than ideal awareness of social appropriate behavior can be shoved onto this broad spectrum and receive a 504 plan excusing angry outbursts at school rather than accepting consequences for acting out and hurting other children. Ten years ago, these same children were being diagnosed with anxiety and depression and treatment reflected that diagnosis.

The author's hypothesis is an interesting one but left me feeling like the hypothesis was not settled. My belief is that mood disorders or mental instability is not a good predictor of leadership skills. I didn't see the connection as the author presented the information. I wanted to be convinced with hard evidence but instead, I was underwhelmed.
Profile Image for Ahmed.
914 reviews7,712 followers
January 10, 2020
جنون من الطراز الرفيع.....ناصر قائمي

كتاب عظيم فوق الوصف، دراسة مبجلة عن معاناة أعظم قادة العالم في تاريخه مع الأمراض النفسية، مع تحليل ممتاز عن تأثير المرض في مسيرتهم.

كان مدهش لي بشكل خاص كلام المؤلف عن شخصيتي لينكولن وتشرشل وكيف ساهم اكتئابهم الحاد في نجاحهم لقيادة بلدهم في أسوأ فترات ممكنة.

الكتاب عالمي، بمعنى انه هيلمس مع كل قاريء تفصيلة أو رأي بخصوص الحكام، ولاسيما منطقتنا العربية.

جزء التحليل النفسي ودراسة المرض النفسي مميز جدا الحقيقة، والربط ما بينها وبين واقع الحكام كان في غاية السلاسة.

كتاب ممتاز في المطلق بترجمة جيدة وأرشحه بقوة.
Profile Image for David Rubenstein.
821 reviews2,665 followers
October 21, 2014
Nassir Ghaemi describes a strong correlation between mental or mood disorders, and leadership. Many of the world's best leaders in times of crisis had mental disorders--not very severe, but sufficiently ill so that they handled challenges with more realistic outlooks than so-called "normal" people. However, they do not do well during normal times. They do not make good managers.

On the other hand, "normal" people--which he calls "homoclites", can be good leaders during normal times. But they often do poorly when faced with extraordinary challenges.

Ghaemi's evidence for his hypothesis is largely anecdotal. He describes the lives of some of the world's great leaders during times of crisis; Winston Churchill, Abraham Lincoln, General Sherman, John F. Kennedy, Martin Luther King Jr., Franklin Roosevelt, and Gandhi. He showed how adversity due to mental illness often prepared them for challenges later in life. Churchill was an active politician during the early twentieth century, but became a political "has-been" during the 1930's. However, he foresaw the Nazi threat before any of the so-called "normal" politicians like Chamberlain. Ghaemi attributes Churchill's insight to the challenges he faced with manic depression.

Ghaemi contasts General Techumseh Sherman, who took big risks during the American Civil War, with the more staid General George McClellan. Sherman suffered from hallucinations, was suicidal and depressed. John F. Kennedy suffered from a number of physical and mental problems. Franklin Roosevelt was challenged by the adversity of polio. Both Martin Luther King Jr. and Gandhi had depression, and contemplated suicide. Nevertheless, all of these leaders took risks, were courageous, and were great leaders. Ghaemi contends, however, that during normal times, these leaders were ineffective. On the other hand, leaders like George W. Bush, Tony Blair, and Neville Chamberlain were ineffective leaders during times of crisis, as they were mentally "normal", and were simply not prepared for times of adversity.

The book also discusses Hitler and other Nazi leaders during the World War II. Ghaemi discusses how Hitler had mental problems that were exacerbated by bad medical treatments. Ghaemi argues that Hitler's example also is evidence in favor of his hypothesis--but I am not convinced, and he turns around and shows how many (but not all) of the Nazi leaders were "normal" from a psychiatric point of view.

This is definitely a thought-provoking book. While I found it difficult to believe that Ghaemi's hypothesis is generally applicable to all leaders, he shows enough evidence to prove that the effect is not mere correlation--there is probably some causation in effect, too. Anybody interested in psychology and history would find a lot of compelling insights in this book.
362 reviews4 followers
August 2, 2023
This book would have gotten three or four stars had its theme been slightly different. The author posits on p. 17, "The best crisis leaders are either mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy." Had the book stuck to the specific cases, that is, something closer to "Here are some amazing leaders who had mental illness, and I would argue that their illnesses helped inform and shape their successful leadership," I could have backed that thesis 100%. I can't help but wonder about which historical leaders were potentially not successful because of mental illness, or maybe they didn't have the opportunity to shine because they didn't have the right crisis to lead through. President Franklin Pierce comes to mind, who is said to have suffered from depression, as an example. He had pre-Civil War issues to deal with, among other problems, but has been ranked one of the least effective presidents by historians. Was this a matter of the wrong crisis? Not enough coping skills?

On page 223, the dismissal of the leadership contributions of Truman and Eiserhower took my breath away: "I would say that they were homoclites [people of normal mental health], but that their presidential successes did not include handling major crises, like World War II (almost over when Truman took office). . . or the civil rights crisis (Eisenhower briefly intervened in Little Rock, and otherwise avoided conflict)." First, Truman took a very Shermanesque approach to war, dropping two bombs that killed well over 100,000 people, many of them civilians, in order to stop the conflict and preserve the lives of hundreds of thousands more. No nod to that, given that Sherman was an inspriation for this project? How is Truman's decision not bold and forward thinking? Wasn't that decisive action in a crisis situation? And perhaps Eisenhower's presidential leadership wasn't challenged in a way that allowed him to stand out, but what about his performance during World War II in Africa and Europe? As Supreme Commander in both places, surely he had plenty of crises that he handled, and handled well, given the outcome of the conflict?

That was the point at which the author lost me as a reader, because I didn't trust him to be looking at the material objectively. It's not a coincidence, I suspect, that I found the sections on mentally healthy leaders to be the weakest parts of the book. Also, there was some carelessness in language; for example, "A depressive person sleeps less, and the nighttime becomes a dreaded chore that one can never achieve properly" (p. 17).

A final question: Assuming leaders with mental illness are indeed the best kind to have during a crisis, what then? Should voters be trying to elect depressive or hyperthymic leaders? How do we determine this when such information is usually hidden from the public? How do voters anticipate the crises that might necessitate different types of leadership?

I had high hopes for this book, and I do admire the author for his ambition, but a slightly different approach would have made it better.
Profile Image for فهد الفهد.
Author 1 book5,032 followers
February 15, 2016
جنون من الطراز الرفيع

رغم انتقاداتي إلا أن هذا كتاب من الطراز الرفيع، يتتبع فيه ناصر قائمي سير زعماء غربيين وزعيم شرقي واحد – غاندي -، ليخلص إلى خلاصة مهمة وهي أنه لا يشترط الصحة العقلية في الزعماء، وخاصة في أوقات الأزمات، مقارناً بين تشرشل وتشمبرلين وبين شيرمان وبقية جنرالات الحرب الأهلية، كان الزعماء العاديون يزدهرون أوقات السلم، ولكنهم يفشلون في أوقات الأزمات، فيما يزدهر المصابون بالاضطراب ثنائي القطب (الهوس والاكتئاب)، يفسر قائمي ذلك بصفات معينة يثيرها هذا الاضطراب وتكون فعالة في هذا الموضع، وهذا برأيي قد لا يكون حاسماً، هل يمكننا الجزم ونسبة نجاحات هؤلاء الزعماء إلى حالتهم العقلية؟ وهل درست في المقابل حالة زعماء آخرين عانوا من ذات الاضطرابات وفشلوا؟ وزعماء عاديين نجحوا في أوقات الأزمات؟ الأمر يحتاج إلى دراسة أعماق من المتخصصين ولكن الكتاب مثير جداً، وأتمنى لو درست كذلك الحالة العقلية للزعماء العرب.
Profile Image for Cari.
280 reviews160 followers
June 12, 2013
The Good

A First-Rate Madness has a fascinating premise: that in times of crisis, mentally abnormal leaders are more effective than mentally healthy ones. For various reasons, many of which are included in this book, I actually tend to agree with the author, and even if I didn't, his theory would be intriguing food for thought. Additionally, Ghaemi writes well and is consistently engaging, keeping his work from becoming dry as one reads.


The Bad

I have extreme reservations about the evidence Ghaemi gives to support his claims. There's a lot of cherry picking, both of subjects and of symptoms. Clearly no book can cover every major world leader, but he's chosen to highlight only a very few when simply shortening the sections on each would've made room for a larger, more varied sample size. Additionally, any studies that don't agree with the theme are brushed aside, and the symptoms he focuses on in the case of each leader are clearly cherry-picked from often limited available information. One suspected incident of depression does not a depressive or bipolar make; half-hearted juvenile attempts at suicide do not denote a suicidal or depressed adult. Beyond even that, there's a lot of assumptions made and only the flimsiest of contexts given, which makes me wary of putting much stock in the "examples" on which Ghaemi basis his ideas.

I think the idea is good and deserves major study, and I would love to read the result of one. Unfortunately, this isn't it.


The "What the Hell?" Moment

So I was nearing the end of the book and all was going pretty well, I was disappointed but still intrigued, and while I hadn't yet settled on my rating (since I hadn't yet finished reading), I figured things would hold steady until the end. And then I reached the top of page 257 and, as Ghaemi is discussing the negative stigma attached to mental illness, he writes this:

"This stigma is the basis, I think, for most of the intuitively negative reactions that readers may have to this book's theme."

Passive aggressive attempt to foist any failures of the book onto the reader? Sorta seems that way. It's not the theme that gets a negative reaction, sir, but the sparse study and supporting information. Perhaps he meant it innocently (I'm sure many will agree that he did), but for me it shows a distinct lack of faith, either in his work or his readership, neither one of which is forgivable. So really, Nassir Ghaemi, what the hell?


The Summary

An excellent theory, intriguing and deserving of further work, but the book itself fails to deliver on its premise and makes the factual, scientific side of me squirm uneasily. Take it or leave it, the book doesn't make much of a difference either way.
Profile Image for Joselito Honestly and Brilliantly.
755 reviews366 followers
August 12, 2019
Is President Rodrigo Duterte of the Philippines mentally ill?

If he is, then he could either be the worst type of leader or the best one for the country, depending on where the Philippines is now. For the theme of this book is summed up this way: “The best crisis leaders are either mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy.”

Elucidating, the author wrote:

“In times of peace, mental health is useful. One meets the expectations of one’s community, and one is rewarded for doing so. In times of war or crisis, it is the misfits who fill the bill. (German psychiatrist Ernst) Kretschmer noticed this pattern and explained it using the metaphor of bacteria, which replicate and survive only in times of crisis. ‘The brilliant enthusiast, the radical fanatic and the prophet are always there, just as the tricksters and criminals are—the air is full of them,’ but they flourish only during crisis. In peacetime, they are our patients, he famously wrote; we rule them. In crisis periods, they rule us.

“Great crisis leaders are not like the rest of us; nor are they like mentally healthy leaders. They’re often intelligent, prone to poor physical health, the products of privileged backgrounds, raised by parents in conflict, frequently nonreligious, and ambitious. All these personality traits and experiences are also associated with mental illness, like mania and depression, or with abnormal temperaments, like hyperthymia. Much of what passes for normal is not found in highly successful political and military leader, especially in times of crisis. If normal, mentally healthy people…run for president, they tend not to become great ones.”

Mentally ill people are creative. Geniuses are often have the touch of madness in them. One example given was the American Civil War General William Tecumseh Sherman (after whom the Sherman Tank was named). Before him, there was the problem of having too much casualties in the usual head-to-head combats between opposing armies. But he thought of a way to defeat the enemy without necessarily confronting it in battle, i.e., by utterly destroying the cities upon which the enemy gets its support. The problem of having so much military casualty was therefore solved with this cruel novelty but it spawned a new one: civilian casualties and suffering. In the same way, one would notice President’s novel approach in his war on drugs: extrajudicial killings. The obvious aim is not just physically stop (by killing) those involved in drugs, but to instill so much fear among them that, hopefully, the fear would be enough to persuade them to change. It remains to be seen if it is, or will be, successful yet one can readily see the new problem it has created: the culture of death and impunity where one no longer knows who is killing whom and for what reason. Wrote the author:


“These leaders were creative, manic originators: they answered questions nobody had yet asked, but in so doing they produced other questions nobody can yet answer.”


Other leaders who were considered mentally ill were (among others) Mahatma Gandhi, John F. Kennedy, his father Joseph Kennedy Sr., Winston Churchill (contrasted with his “sane” contemporary Neville Chamberlain), and Ted Turner. In times of crisis, they magnificently excelled; but in times of peace they were duds. They’ve all exhibited many of the features of hyperthymia: high energy, elevated libido, workaholism, sense of humour, risk-taking, extraversion, sociability and marked ambition. Noticeably, President Duterte had all these. But is he good for the country? The book answers it this way: if the country is in a real crisis, YES; if the country is not in a real crisis, HELL, NO.
Profile Image for Pat.
1,279 reviews17 followers
January 4, 2012
This book provides an interesting analysis of world leaders & how their mental health influenced their leadership. The author's analysis of such world figures as Lincoln, General Sherman, Hitler, FDR, Nixon, JFK and many others and how they reacted during crisis and non crisis situations depending on his interpretation of their mental health is fascinating. His conclusion is that leaders with certain types of mental illness (bipolar) handle crisis situations better than non mentally ill (normal) personalities. My sister, a psychologist, disagrees with much of his research & findings, but I found his background info on each of the figures enlightening.
Profile Image for Cleokatra.
284 reviews
December 1, 2011
I’m not sure what to make of this one. If I had some money, I think I would buy a few copies and pay some people who have been diagnosed with a mental illness to read this book. I’d really like to know what people with first-hand experience think of this. If you have a mental illness, could you, like, go to the library and then get back to me? Maybe?

Anyway, the basic premise of the book is that people with mental illness are better leaders in times of crisis and mentally healthy people are better leaders when things are boring. The author suggests that people with depression and bipolar disorder are more resilient and mentally flexible because they have experience overcoming difficulties. I guess this is the part that I am questioning. If you are living with depression (and I mean “depression” as in the actual disease, not just a case of the blues) is this because something bad happened to you or is it an issue of brain chemistry or is it both? In my own case, I think my episodes of depression were caused by a combination of bad stuff happening, plus my basic nature as a somewhat gloomy person. It seems to me that a person with better brain chemistry (or whatever) would have reacted to those events in a different way that did not involve being depressed.

As a scientist, I am always aware that correlation is not causation. Another thing I am aware of is that psychology is a “soft” science. I think both those factors are at play here. I think the author found a hypothesis and then cherry picked some observations to support it. That’s easier to do with this sort of science than it is in a field like physics.

In this case, I think the actual causation is not mental illness but introversion and a tendency toward self-examination and reflection. People who think a lot are better at dealing with complex situations because they are used to thinking. They don’t just react emotionally from their “gut”, like an animal. That isn’t the same as a mental illness, though I do think that some people with mental illness may spend more time thinking about their feelings and emotional state. If you don’t feel good, there is more to think about. You think more about breathing when you have a head cold than when you are healthy, right?
Profile Image for Marya.
1,384 reviews
September 6, 2011
"And, isn't sanity really just a one-trick pony anyway? I mean all you get is one trick, rational thinking, but when you're good and crazy, oooh, oooh, oooh, the sky is the limit." - The Tick

From his eminent philosophical standing, the Tick nicely summarizes pretty much the only point in this work's introduction I could accept. The author's thesis, that mentally ill leaders are preferable in times of crisis while sane leaders are better at steering a straight course during non-crisis times, seems over-reaching, especially as he only chooses famous (mostly) dead international leaders to support his thesis. The book is set up more like a historical analysis, and even the author admits psychologists, like historians, often only have modest data upon which to base their conclusions. If you want a more thorough understanding of the book's psychology points, go ahead and read Nancy's review; it does the book more justice than I ever could. Perhaps reading this text as a historical work rather than a work examining the qualities of leadership would be more rewarding.
Profile Image for Elyse.
445 reviews71 followers
September 1, 2022
Fun isn't quite the word to describe this book; but I sure had fun reading it. The title A First Rate Madness is a bit sensational. Maybe the publisher insisted on this title to help sell the book. In it the author, Nassir Ghaemi, is seriously trying to convince his readers that his thesis has merit: that the greatest leaders in world history have suffered from a mood disorder. Specifically bipolar disorder.

Ghaemi stresses that psychiatric diseases have always been considered a negative thing but he tries to explain this isn't always the case. (It reminds me of a 60 Minutes segment I watched on TV the other night featuring autistic adults working and inventing products. They're not stupid - they just have a different way of thinking and talents that the business world has been wasting.) I have no background in psychiatry but I find the author's thesis plausible. In my ignorance I can't refute his facts (oh my gosh, he backs EVERYTHING with notes) so I am easily suggestible. (I prefer saying I have an open mind.)

Throughout the book he repeats his expectation that his colleagues will balk at his thesis. I bet they did.

Ghaemi picked various leaders to analyze from those who have some written record of their psychiatric history. That way he doesn't have to rely entirely on speculation. These bipolar leaders (or those who showed bipolar tendencies) include Churchill, FDR, Gandhi, John F. Kennedy, Ted Turner, General Wm. Tecumsah Sherman, and others. Hitler was bipolar - he fit the profile with disastrous results. By the time Hitler committed suicide in the bunker he was an amphetamine addict. Drugs can usually help someone with bipolar symptoms but not in Hitler's case.

I can't adequately explain Ghaemi's "proof" in this review. If you enjoy mind-bending things to contemplate, like I do, reading this will be a treat.
Profile Image for Kerry.
236 reviews10 followers
February 14, 2013
The psych student in me was extremely excited to open this delectable treat... and it certainly didn't disappoint as by page 2 I get: "in times of crisis, we are better off being led by mentally ill leaders than by mentally normal ones". If you aren't intrigued by that then I think there's an RL Stine or Twilight book out there that might be right up yer alley...

On to the next one...now after studying psych here's what I can tell you: Ghaemi is brilliant for those who don't know in-depth psych - the correlations of varying mental illnesses are short & sweet. In turn he's killer for those of us that have and are dying for more! I may be lurking in a class or two of yours soon Dr. Ghaemi! I mean that in a strictly non-stalkerish way of course.

In short, I think this book is unbelievably fascinating. For a myriad of reasons. It puts a whole unseen light of what mental illness has done to BETTER society. Which in turn just sparks more dialogue and hopefully more understanding of those who suffer from it. Hell for those of us that do its a beacon. For understanding that what "afflicts" us isn't completely a curse but in such a larger social context a blessing...within reason of course. Bc what may be for the best of society is hell within one mans home. A fine line of "genius" is walked, but understood so much more.

Some phenomenal quotes follow within this book as well such as: "Our leaders cannot be perfect; they need not be perfect; their imperfections indeed may produce greatness. We make a mistake, however instinctive, when we choose leaders like us."

In every possible way, there has never been a more incredible and concise argument for why "mental illness" has advanced (and in especially bad environments mixed with the wrong medication, de-evolved) mankind. There need not be a shun on such things IF acknowledged and treated in the right way. It is why in fact, mankind has thrived at points and failed in others.

Mind BLOWN. (Well not really but finally stoked to see someone put in words what society has worked so hard to reject).

I am absolutely sneaking into some of Dr. Ghaemi's lectures if I don't just drop my career and Pursue a phd already. Boom.
Profile Image for Amanda .
774 reviews13 followers
January 21, 2021
We need Richard Nixon to be sick, because we believe we are healthy. If mental health means being a homoclite, then mental health has a considerable drawback: conformity.

The premise of this book is that the best crisis leaders are either mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy. The weakness of mentally abnormal leaders are the source of their strength during political crises. Ghaemi claims that sanity "does not always, or even usually, produce good leadership" and that sometimes, it even hinders it. It can prevent a realistic assessment of a situation and prevent rational decision making in times of a crisis.

Four key elements of the mental illnesses of mania and depression, realism, resilience, empathy, and creativity, seem to promote leadership during crisis. Ghaemi's premise is that these four elements haven't been recognized by historians and they've shaped the twentieth century more than any other factor.

We like our presidents moderate and middle-of-the-road- psychologically even more than politically.

Ghaemi puts a spotlight on a variety of twentieth century world leaders (Lincoln, Churchill, Gandhi, Martin Luther King, Jr., JFK etc.) and compares the ones who were considered to be mentally abnormal to "normal" and he compares and contrasts their actions and the state of their mental health in times of crises. I found this to be utterly fascinating and found myself how he would characterize many of today's world leaders. Beyond spotlighting the less harmless leaders, he also focused on leaders that have been written off as crazy before due to their actions and he examines whether they really were crazy.

Germany and its Nazi leaders were not much different, psychologically, from any nation or any leaders. And that's the scary part.

This was a fantastic book.
Profile Image for Alexis.
78 reviews
February 1, 2017

Let's begin... I never took a psych class in college, and I am essentially self-taught in history, but I could tell almost immediately that I was going to agree with virtually nothing Ghaemi said. First, his definition of madness is purely limited to mania and depression, which I find insulting to anyone who finds themselves on the bipolar spectrum. It is also very clear that Ghaemi found very specific leaders to analyze and then picked out certain characteristics to fit into his thesis. For example, Ghaemi writes about Martin Luther King's suicide attempt as if this is breaking news and that he and he alone was able to uncover MLK's secret pain, and this was the source of his depression, and thus his success.



On this history side of the book, Ghaemi often applied hyperbole in order to make a literary or psychological thread connect. Continuing with MLK, what may have been my single biggest historical issue with the book was when he equated slavery with segregation (76). We can all agree that segregation was an evil practice and, of course, related to slavery through the ingrained racism in the South, but come on! Do you have to make me say it? Slavery is not the same as segregation.



This book is filled with contradictions, tenuous connections, and weak arguments. I do not understand how this book was even published given how ridiculous it is at times. And, as a final note, there are no women mentioned in this book. That may just be enough of an oversight to be unforgivable in and of itself.



Just awful.

Profile Image for Karishma.
121 reviews39 followers
March 25, 2016
I'm a little disappointed because I expected to like this book a lot more than I actually did. I was quite intrigued by the book initially - Ghaemi's thesis being that mental illness lends certain qualities to its sufferers which aid them in becoming more resilient, more realistic, creative and empathetic individuals and thus, more excellent leaders in times of crisis.

So far, so good. However, this cannot be generalised to every leader and the reverse idea that mental health corresponds with poor and mediocre crisis leadership seems a judgmental call to make. I was not really satisfied with the justification he gave for calling 'homoclite' so called middle-of-the-road leaders' failures in leadership positions in war time.

I think the book is at its best when he sensitively speaks of the need for acknowledging the strengths and abilities of those with mental illness, or atleast, those with mood disorders. As a student of psychiatry myself, I find it hard to take a call on whether an illness such as psychosis with its known profiles of cognitive impairments that are part of the illness process will not in the long term impair judgment or in fact, if such stress as is notably associated with leadership positions won't worsen the illness itself.

There are no easy answers and the call to end stigma against mental illness in our society is timely. However, the idea remains that perhaps there is that in individuals other than a first-rate madness that makes them first-rate leaders and if it takes more than just depression to teach someone empathy and kindness.
Profile Image for Steve.
107 reviews
November 13, 2011
I found this book not only fascinating but a compelling idea. The author contends that the best leaders during times of crisis are those with a mental illness. He suggests this is the case for only certain illnesses which are severe depression, mania, bipolar disorder, and hyperthymia . His idea is that depression makes one a realist and empathetic while mania makes on creative and resilient. He gives numerous examples including General Sherman, Abraham Lincoln, Winston Churchill, MLK, FDR, JFK and even Hitler. He then discusses leaders who are "normal" that have not done well in times of crisis. These include General McClellan (vs. Sherman), Neville Chamberlain (vs. Churchill), Richard Nixon, Tony Blair, and George W. Bush.
Profile Image for Avis Black.
1,764 reviews47 followers
August 12, 2023
The author has let his political opinions determine how he makes his psychiatric analysis, which is poor professional judgment. His main idea is that a dose of madness makes a leader better. He does not consider that some leaders are talented despite their illness, not because of it. Nor has he bothered to perform the sort of comprehensive survey that might back up his point. His cherry-picking carefully avoids leaders like Idi Amin, or the Emperor Caligula, or Ivan the Terrible, all of whom had Ghaemi's beloved and requisite mental illnesses.
Profile Image for Ellen.
Author 1 book53 followers
April 16, 2019
Was not impressed with this book's argument that mental illness correlates with great leadership in times of crisis. People who struggle with mental illness absolutely can make great leaders but this thesis was structured quite poorly and buttressed by examples that were almost all white straight male military leaders (and chapters about Gandhi and Dr. King were frustratingly shallow).
Profile Image for Nasser Moh'd.
207 reviews140 followers
June 4, 2017
كتاب رائع يتتبع فيه عظماء وزعماء العالم الذين صاحب مسيرتهم القياديه "مرض نفسي" وخلق من رحم المعناة الأبداع ، الكتاب ممتع لأنه يكشف وللمره الأولى أن للمرض النفسي أسباب في النجاح والخلق والابداع والتحدي .
Profile Image for Liquidlasagna.
2,318 reviews76 followers
April 25, 2021
"In times of crisis, we are better off being led by mentally ill leaders than by mentally normal ones."

Is it me or does the author come off like a fifteen year old jerk in a debate?

---

"Yet, Nixon's drinking, in particular, appears to have been exaggerated."

Maybe when he's quoting Hunter S. Thompson to set up his argument.

---

"Nixon was not routinely vindictive, as many believe."

"In American politics, the standout here is probably Richard Nixon. His fall is legendary, and so is the popular perception of him as paranoid, depressive, and even delusional. But in fact he was none of these things, except during a relatively brief period at the end of his presidency, when he was engulfed in a crisis of his own making. Before that crisis, he might well have been called successful and, as I will show, mentally healthy."

"Bush and Blair were normal; so too, mostly, was Nixon; so too were one group of leaders commonly assumed to be abnormal: Nazis. I have already discussed Hitler, whose bipolar illness is consistent with the thesis of this book. Helpful initially, it becomes a determent when combined with years of intravenous amphetamine treatment. We are left with other Nazis. Weren't they sick men?"

"Most important, in comparison with the psychiatric and antisocial controls, the Nazi leaders demonstrated 'no' evidence of psychosis at all, and hardly any antisocial personality traits. Indeed, the group that they approximated most closely was the "normal" Kansas state troopers."

"In contrast, as I've tried to show, most Nazi leaders were not mere followers, nor were they insane; they were true believers, ideologues, rational fanatics - but from a psychiatric perspective they were mentally healthy."

"We make a mistake, however instinctive, when we choose leaders like us. This is our own arrogance, as normal homoclitic people. We overvalue ourselves; we think, being normal, that we are wonderful. We stigmatize those who differ from us, whether because of race, sex, habits, culture, religion - or, perhaps more viscerally, because of mental illness or abnormal behaviors."

"As we have seen throughout this book, the greatest leaders are often abnormal, even flat out mentally ill. We should accept, even celebrate, this possibility.'



---

reviews

"The view of Nixon as dangerously sane will come as a surprise to an entire generation of Nixonologists."

"Flawed history, partisan politics"

"This book is highly biased to say the least, JFK had a mental health issues but LBJ did not. JFK had a mental health issues but Nixon did not even though a famed Psychiatrist claimed to have treated Nixon while Vice President."

"The author takes every known mental illness known to man and tries to find somebody in history who kind of, somewhat, maybe has the slightest hint of those symptoms. Spends WAY more time trying to justify the connection than giving an accurate portrayal of the historical figures he discusses. However, if I'm grading this as a sleeping aid, I'd give this five stars."

"The author constantly mixed mental illness with abnormality and even with someone on the ends of the bell curve of normality. He completely dismissed any insights into the power of positive thinking or free will to change one's own outlook or lot in life. To Ghaemi anyone extremely extroverted, full of life, highly inquisitive, or highly analytical would be somewhat, if not totally, mentally ill. Throughout the book the author tried to put the characters in historical context but the history was very weak and I was constantly wanting to check his history as they always seemed vaguely incorrect, or out of context. This was true also with his discussions about psychotherapy and psychiatry."

"The reasoning about leadership is also flimsy. If mood disordered individuals can make great leaders, it seems silly to conclude that the best leaders in troubled times are people with a mood disorder."

"there is a lot of interesting material here, if you can bear watching it mangled to fit Dr. Ghaemi's theory"

"Not a First-Rate Book. Dr Ghaemi's book goes awry right of the bat with its title which promises that we are going learn juicy stuff about madness and mental illness in our leaders. But unfortunately he plays fast and loose with terms."

"By being loosey-goosey with his definitions, by forcing his analyses into a power-point-like presentation, and because of his glibness and sloppiness with his evidence, he really doesn't get us anywhere very worth going."

"Ghaemi sees the world through his lens of expertise in bipolar and depressive illnesses. Thus if someone doesn't fit his four categories for determining mental illness, he isn't mad. Thus, JFK is, but Hitler isn't. FDR is, but George W. Bush isn't."

"I also disagree with Ghaemi's characterization of personality tendencies. He sees the three dominant "mentally ill" types as hyperthymia, dysthymia and cyclothymia. Thus again, since Hitler doesn't in his view fit one of the three abnormal types, he is not mentally ill."

"This book is an oversimplified account of people and history. The author never states what it means to be a good leader. Does locking people up for speaking out against you and suspending dues process make you a good leader? Does wanting to change the rules surrounding a 200 year old institution because you can't get your way make you a good leader? If so, then yes Lincoln and FDR are good leaders. If not, then they are not and the entire premise of the book is bunk."

---

The reviews on the back should disturb you more than the actual book.
Heck, any good reviews of this book should disturb you.

Profile Image for ليلى المطوع.
Author 2 books1,816 followers
June 30, 2016
حسنا كنت متشوقة لقراءة هذا العمل، الجنون الذي سيطر على اشهر الحكام وكان سببا في اتخاذ قرارات مصيرية، خاصة في وقت الازمات،
هل وجدت مااريده في الكتاب؟
كلا؛ الجانب الذي يدور حول سيكولوجية الحاكم المريض لم يكن كافيا، ولامقنعاً ، رغم محاولات الكاتب ذو الصوت العالي، اقناع القارئ بالادلة، وهذه الادلة هي مقتطفات من حياة الشخصية المطروحة في العمل، الحجة كانت ضعيفة خاصة واذا بحثنا عن زعماء واشخاص ناجحون لم يعانو من ثنائية القطب "المرض الذي جمع الشخصيات في هذا الكتاب" او اي مرض عقلي وكان لهم دور في تطوير اوطانهم او انجاح مشاريعهم والخ...
او كان لهم دور اقوى من الشخص السليم في الازمات ولاسباب بعضها مقنع والاخر لا

استفدت من المعلومات التاريخية والجوانب التي كنت اجهلها من حياة الزعماء وبعض الصفحات التي تتحدث عن علم النفس بشكل مباشر وتحلل بعض الصفات الانسانية

ضحكت من الكاتب حين شرح عن حال شخصية انه منذ الصغر كان يعاني من العدوانية في عقله اللاواعي، حيث كان يهرس البطاط
اي حجة ساذجة هذه
ومازاد الطين بله هو محاولته اقناع القارئ بصحة المحتوى وذلك بالحديث عن نفسه بدلا من اقناعه بادلة واضحة وعقلانية


Profile Image for Ashley.
177 reviews9 followers
April 26, 2021
Misinformation on dates such as Wendell Willkie being cited on the ballot in 1944 instead of 1940. He wrongly dates Kennedy as well. That aside, the book is all over the place. It seems Ghaemi is "practicing history without a license". He takes on huge figures such as Martin Luther King Jr, and Ghandhi and finds way to demeaningly patronize their plights; all due to severe mental illnesses. Why aren't there any female subjects discussed? I find the tone of the book to be condescending. He tries to hard to make his point and it becomes convoluted in his patronizing/one sided view of history. I did not like this book at all.
Profile Image for Anna Juline.
429 reviews
April 13, 2017
I read this book for my psych discussion group, and we disagreed with so many of his claims. He didn't have very much evidence for some of the people he analyzed, and some of his diagnoses seemed like major reaches. There were some strong chapters, but he could have done without probably half of the book. One statement that really bothered me was about how all of Germany was guilty for the Holocaust. I think that isn't a claim anyone can make...either you blame the Nazi party and Hitler, or all of humanity for letting it happen. However, I didn't hate the book completely...he did have some good ideas that could have been improved upon.
Profile Image for Ben Dubielak.
55 reviews
January 16, 2021
I found this thoroughly engaging and a fairly detailed examination of historical leaders and the mental illnesses they dealt with.

Though I'm not sure I agree with his thesis fully, (namely "In times of crisis, we are better off being led by mentally ill leaders than by mentally normal ones"), he provides enough strong circumstantial evidence to make a compelling case.
Profile Image for Stephanie.
1,051 reviews45 followers
July 24, 2017
   Our leaders cannot be perfect; they need not be perfect; their imperfections indeed may produce their greatness. The indelible smudges on their character may be signs of brilliant leadership.
   We make a mistake, however, when we choose leaders like us. This is our own arrogance, as normal homoclitic people. We overvalue ourselves; we think, being normal, that we are wonderful. We stigmatize those who differ from us, whether because of race, sex, habits, culture, religion—or, perhaps more viscerally, because of mental illness or abnormal behaviors. – 70.4%/Chapter 15

   Dr. Ghaemi offers an insightful, compelling analysis of numerous historical leaders and possible psychological factors contributing to their greatness… or their failures. He mostly focuses on depression and manic-depressive disorder, but also pays attention to the personality types of dysthymia, hyperthymia, and cyclothymia (with hyperthymia being the most evident in his case examples). It is worth noting his methodological approach to laying out his chapters, and that he actually found more evidence to support conclusions which ran contrary to what he expected to find – thus showing that while he had a pre-supposed notion of what he would find, that he took the time and kept his mind open to discover other possible explanations.

   While reading the presentations of each historical personage, I did feel like there was something almost too casual with the way Dr. Ghaemi presented the information – it was not quite as scientific as I had expected, excepting when he threw in new terms swiftly followed by their definition/explanation. Though this did mean that it makes for a very accessible read, and not dumbed-down for the non-scientifically-oriented masses. It’s almost light enough to make for an upper-level beach read, but not so light that the reader does not take what he has to say seriously. As this was written during Obama’s first term in the presidency, it does show some dating with comparisons based on new information which has since come to light and the latest developments in US politics/US political leaders. It would be interesting to take his methodology and apply it to more current politicians; I am curious about what a psychological evaluation would mean on at least one high-office holder at this time. But even Dr. Ghaemi recognizes that historical distance assists in making a more accurate, less biased analysis of the person in question, and that analyzing someone too contemporary/still living/still in office would be bound to get too controversial and colored by personal thoughts and opinions.

   The length of the bibliography and the notes section also lend credence to Dr. Ghaemi’s analysis and conclusions, as he has clearly done a lot of research and spent much time reading various historical documents in order to glean any information possible that might better frame each historical leader in their political, emotional, and intellectual contexts.

   All in all, this made for a very interesting read, a different way to look at some historical leaders, both successful ones, failed ones, and off-the-deep-end ones. I make a few additional insights in my status updates for those of you interested.

Notable quotes/selected commentary
   For Roosevelt, reporters were potential friends to be won, rather than enemies to be avoided. – 36.6%/Chapter 10 – I think someone could use this as a new MO…might help him “discourage” the “fake media” by actually trying to connect with them instead of shutting them down.

   In August 1973 […] One psychiatrist was quoted in Time magazine as saying that Nixon’s behavior was consistent with schizophrenia. No president before or since has ever received such unwanted psychoanalytic attention. – 59.7%/Chapter 14 – That might soon be surpassed, if anyone still takes the psychoanalytic approach these days…

    [Murray Chotiner’s political working precepts were:] People don’t vote for someone; they vote against someone. Chotiner’s second rule was that voters possessed the mental capacity for grasping just two or three issues at one sitting. – 61.2%/Chapter 14 – I’d say we’ve definitely seen this recently.

    […] despite JFK’s concerns that Nixon would assail him for “girling,” Chotiner’s pupil focused on political, not personal, attacks. – 61.3%/Chapter 14 – Not at all like the 2016 US elections, where personal attacks were rather the norm…

   As discussed in chapter 1, one sign of creativity is “integrative complexity,” the ability to see things from multiple perspectives. – 63.7%/Chapter 14 (emphasis added)

   Most people have a hard time admitting error, apologizing, changing our minds. It takes more than a typical amount of self-awareness to realize that one is wrong and to admit it. – 64.1%/Chapter 14 (emphasis added)

   Of course Lincoln and Churchill hid their severe depressions from their respective electorates. But will we, as a society, ever evolve to the point where we can seek out our Lincolns and Churchills instead of getting them despite ourselves? – 69.5%/Chapter 15 – Time will tell which we’ve got this time around…

   Can we applaud passion, embrace anxiety, accept irritability, 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. – 69.7%/Chapter 15 – As long as they work for the benefit of the country, that is…

Two longer excerpts under the cut, where I also come off a little strong because it’s late, I’m tired, and my personal filter isn’t 100% properly adjusted at the moment:
   

Typos:
“[…] Every since I was little….” – 11.7%/Chapter 2 – should be “ever”

…while we delight to listen to him in this House we not take his advice… 18.3%/Chapter 4 – should be “we do not take”

…have suffered the same illness.
IF GANDHI INDEED suffered… -- 25.4%/Chapter 7 – missing an extra line break in between paragraphs

…those who are immu-nocompromised… -- 44.4%, chapter 11 – should be “immuno-compromised”

Your excellency Major Kelly! – 67%/Chapter 14 – Possibly a typo, unless the error was in the original letter, as it is “Kelley” everywhere else.

…in latenineteenth-century Italy… -- 68.7%/Chapter 15 – missing a space after “late”

(accessed Apirl 4, 2011) – 75.6%/Notes – misspelling, should be April

…three highestrating presidents… -- 89.8%/Notes – missing a space after “highest”

…ideology (leftwing versus right-wing)… -- 90.1%/Notes – missing a dash – “left-wing”
Profile Image for Wael Al-Shail.
12 reviews22 followers
July 14, 2017
في أزيد من ثلاث مائة صفحة يؤكد ناصر قائمي، وهو طبيب نفساني أمريكي إيراني الأصل، إن قدرًا من المرض العقلي، يشكل عنصرًا أساسيًا من عناصر نجاح القادة، والزعماء العظام في إدارة الأزمات. وهذا قيد هام، إذ أن الدراسة تخلص إلى أن القادة/الزعماء الذين يتمتعون بصحة عقلية جيدة، صالحين للقيادة في أزمنة السلم والاستقرار، بينما يتفوق أولئك الذين يعانون من مرض عقلي في أوقات الأزمات. والأمراض العقلية لا تحد من مهاراتنا، بل على العكس ربما تساعد على تطوير وتنمية قدراتنا، مثلما يقول الطبيب الألماني كريتشمر: الجنون ليس حدثًا مؤسفًا، ولكنه حافز لا غنى عنه للعبقرية.
ويحدد قائمي أربعة عناصر أساسية لبعض الأمراض العقلية -من قبيل الهوس والاكتئاب- من شأنها أن تطور القدرة على إدارة الأزمات، وهي: الواقعية، المرونة، التعاطف والإبداع. فالاكتئاب يجعل الزعماء أكثر واقعية وتعاطفًا والهوس يجعلهم أكثر إبداعًا ومرونة.

يعرض المؤلف لحياة ثمانية من أشهر القادة والزعماء السياسيين ورجال الأعمال الذين تكشف سيرهم عن ترابط واضح بين الجنون والزعامة، وهم: شيرمان، تيد ترينر، ونستون تشرشل، وأبراهام لينكولن، والمهاتما غاندي، ومارتن لوثر كينغ، وفرانكلين روزفلت، وأخيرًا جون كيندي. يدرس قائمي الظروف التي واجهها كل منهم والتي تمثل جوانب مختلفة للعلاقة بين الصحة العقلية والزعامة. وفي هذا الصدد تمثل حالة الجنرال شيرمان ورجل أعمال الكابلات الشهير تيد ترينر شاهدًا حقيقًا على مساهمة أعرض الاضطراب ثنائي القطب في تنمية القدرة على الإبداع، بينما تكشف مسيرة حياة لينكولن، وتشرشل عن العلاقة بين الاكتئاب والواقعية. وتعد حياة كل من غاندي ومارتن لوثر كنغ مثالًا واضحًا على الترابط البيّن بين الاكتئاب والتعاطف. وأخيرًا تعكس حالة كل من روزفلت وكيندي العلاقة بين المرض العقلي -فرط المزاج تحديدًا- والمرونة.
ويضع الكاتب في المقابل خمسة نماذج لزعماء أسوياء فشلوا في إدارة الأزمات، وهم: ريتشارد نيكسون، جورج ماكليلان، تشامبرلين، وجورج بوش إلى جانب توني بلير.
ويعتمد قائمي في تشخيصه على أربعة مؤايدات أساسية، هي: الأعراض، الوراثة، مسار المرض، والعلاج. حيث تعتبر الأعرض المصدر الأول والأكثر وضوحًا من المؤيدات، بينما تمثل الوراثة مفتاحًا مهمًا لتشخيص الأمراض العقلية، ومع أن مسار المرض والعلاج لا يعطيان في الغالب نتائج دقيقة إلا أن الكاتب أخذهما بعين الاعتبار.
الكتاب ماتع ويقدم تحليلات ممتازة للمهتمين بفهم سيكولوجية المكتئبين، ثم إنه يطرح أسئلة مهمة ويختبر مفاهيم مترسخة عند أكثر الناس. صدر الكتاب عن دار جداول وترجمه الدكتور يوسف الصمعان ترجمة جيدة ورصينة.
362 reviews70 followers
January 29, 2012
Excellent book. Profiles Lincoln, General Sherman, Hitler, Gandhi, Churchill. MLK. FDR. JFK and Ted Turner.

Original writing. Interesting parallel between this book and How Great Generals Win, which also extensively profiles General Sherman, among other strategists.

Dr. Ghaemi focuses on "manic-depression" (or bipolar disorder), and compares this to what we call "normal" personalities, IE, people with a "general feeling of well being".

Great leadership benefits from a few qualities that the "mental health" community, and the "general public" would classify as "mental disease". Those qualities include:

* Resilience: Able to persevere despite all obstacles.
* Depressive Realism: Able to accurately see the complete situation, and their ability to change it.
* Creativity/Unconventional: Ability to mystify the enemy, to apply the art of war.

On the contrary, the "well-adjusted" person is often not suited to be a good leader, particularly when they have nearly complete power, because self delusion prevents them from seeing "reality".

Based on my own life experience, in and around positions of (varying degrees of) power, I would agree with most of what Dr Ghaemi writes.

The main thing I would questions, is whether or not we have our definitions backward?

How is someone, in fact, most people, who are "consistently wrong", defined as "healthy"?

To me, this is as preposterous as US treasuries being defined in economics text books as "risk free treasuries".
Profile Image for Jennifer.
13 reviews
September 22, 2012
As asocial studies teacher and a mental health professional, this book grabbed me right away. I enjoyed learning about his theory and how some of the characteristics of mental illness can be a benefit to leaders. I also think it does a good job of alleviating some of the stigma associated with mental illness. My respect for leaders was also increased when I learned of their struggles and at the same time how much they led a nation or group of people. That being said, I think it is important to read it with a healthy dose of skepticism and critical thinking. Some of his diagnosis were weak and based on little evidence. Sherman and Lincoln had a lot of material to back up a diagnosis but I was not convinced of MLK Jr.'s or Ghandi's diagnosis's. the author stated repeatedly there was little evidence to support the diagnosis but did so anyway with what little evidence he had. I'm not saying he is wrong, merely that he could be. I don't think you can claim a lifetime of depression over an adolescent suicide attempt. Many people attempt suicide and then don't battle depression again. And one of the major critical thinking skills of research analysis is correlation does not equal causation. For many of these leaders we can't guarantee that their mentally illness caused them to be better leaders in times of crisis or whether their illnesses were exacerbated by the crisis they endured.

I did enjoy the historical information and do believe the author has a point about how mental illness can have its benefits but every example did not convince me.
Profile Image for Annelise.
68 reviews6 followers
December 6, 2013
This book is really, really bad. The author is a psychiatrist but is trying to use history to make a point about mental health. He fails to follow basic standards for history. What constitutes "historical evidence" is that if it proves his theory for a figure to be mentally ill, then that person was mentally ill.

I actually agree with the basic premise so I am not even a skeptical reader. The medical parts were interesting but the historical parts - that is, the bulk of the book - were abysmal. Really, tremendously awful.

He should have co-authored it with a historian or should have stuck to his day job. Don't waste your time.
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