Newsletter #465 – Leadership and Mental Illness

Do you ever question the mental stability of many who become leaders or who run for political office? I certainly do and with good reason, according to Nassir Ghaemi, author of A First Rate Madness: Uncovering the Links Between Leadership and Mental Illness. In this fascinating, well-documented book, a psychiatry professor (at Tufts and Harvard Medical schools) argues that some of our greatest leaders were mentally ill – including Lincoln, Churchill, Gandhi, Roosevelt, Kennedy, Martin Luther King, Hitler and a few contemporaries including Ted Turner. No theologians or mental health professionals made the list but one book could not include everybody.

Ghaemi proposes four criteria for determining mental illness: clear symptoms, family history, course of the illness, and evidence of treatment. The book’s conclusions are surprising. “Sanity does not always, or even usually, produce good leadership,” During normal times, presumably healthy leaders like Jimmy Carter or Nelson Mandela do their jobs relatively well but in times of crises, leaders like these are often ineffective. Some are unwilling or unable to accept criticism, disinclined to see reality that contradicts their biases, unable to make realistic assessment or wise decisions. In contrast, mentally ill leaders often don’t function well in their daily work but they can be great leaders in crises. In part because of their increased sensitivity, (often unrealistic) optimism and willingness to take risks  ‘the best crisis leaders are mentally abnormal [unlike] the worst crisis leaders who are mentally healthy.” Churchill meets the criteria for mental illness and he was a great wartime leader who was not equally impressive in times of peace.

Before rejecting these conclusions you might benefit from reading the book – but only if this is of special interest. It’s an interesting example of “psychological history,” offering an analysis about leadership and mental stability. But the book offers few practical conclusions or applications. And it does not shed light on the wisdom of selecting more mentally unhealthy leader wannabes.

Before you vote or decide not to vote in selecting a leader, please click on comment and give your observations. If you have read the book please tell us your reaction.


  1. This is an interesting discussion. I think that how we define mental ‘health’ is not as clear as we like to believe. Despite having mental health symptoms, people can continue to be functional and offer a vital contribution. Sometimes marching to the beat of a drum that seemingly everyone wants silenced can create the most unique thinking. Most people from time to time experience symptoms that could be considered mental illness, but I think that is a reaction to stress, environment, personality, and circumstance. Perhaps the circumstance makes the madness?


  2. Amen. Circumstances and the ability to respond as opposed to react, could require solutions and behavior that in different times and places would be abnormal…but then what is normal?


  3. Well known German author and psychiatrist, Manfred Lütz, argues that mental disorder needs to be defined by the lack of the individual freedom to chose ones own action. He comes to the opposite conclusion: while there may be some personality dysfunction, leaders – even evil leaders like Stalin, Hitler or Gaddafi – show that they were able to chose freely what to do at any time. He concludes that they were not mentally ill but evil. Also he argues, that very few mentally seriously ill patients would be able to plan and pull through with the sort of strategic determination these leaders show. I havn’t (yet) read the book but think that health professionals tend to include more and more normal behaviors into the pathology-drawer because we are trained to see pathology. Not at last because that helps us to fill our private practices with well-paying and easy-to-go but not really disturbed clients. Also, because we no longer use absolute values to discern what is good and bad — so the “evil”-category doesn’t work for us.


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