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

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Format: Hardcover, 352 pp.
ISBN: 9781594202957
Publisher: Penguin Press HC
Pub. Date: August 4, 2011

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Description and Reviews
From The Publisher:

An investigation into the surprisingly deep correlation between mental illness and successful leadership, as seen through some of history's greatest politicians, generals, and businesspeople.

In A First-Rate Madness, Nassir Ghaemi, who runs the Mood Disorders Program at Tufts 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 at once controversial and compelling: 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 astute analysis of the historical evidence with the latest psychiatric research, Ghaemi demonstrates how these qualities have produced brilliant leadership under the toughest circumstances.

Take realism, for instance: study after study has shown that those suffering depression are better than "normal" people at assessing current threats and predicting future outcomes. Looking at Lincoln and Churchill among others, Ghaemi shows how depressive realism helped these men tackle challenges both personal and national. Or consider creativity, a quality psychiatrists have studied extensively in relation to bipolar disorder. A First-Rate Madness shows how mania inspired General Sherman and Ted Turner to design and execute their most creative-and successful-strategies.

Ghaemi's thesis is both robust and expansive; he even explains why eminently sane men like Neville Chamberlain and George W. Bush made such poor leaders. Though sane people are better shepherds in good times, sanity can be a severe liability in moments of crisis. A lifetime without the cyclical torment of mood disorders, Ghaemi explains, can leave one ill equipped to endure dire straits. He also clarifies which kinds of insanity-like psychosis-make for despotism and ineptitude, sometimes on a grand scale.

Ghaemi's bold, authoritative analysis offers powerful new tools for determining who should lead us. But perhaps most profoundly, he encourages us to rethink our view of mental illness as a purely negative phenomenon. As A First-Rate Madness makes clear, the most common types of insanity can confer vital benefits on individuals and society at large-however high the price for those who endure these illnesses.


No one who reads this brilliantly insightful book will ever look at history or politics the same way. Ghaemi uses his deep knowledge of medicine and psychiatry to take readers on a fascinating voyage into the minds of great leaders. His conclusions are startling, provocative, disturbing and deeply persuasive.
—Stephen Kinzer, author of Reset, Overthrow and All the Shah's Men

Nassir Ghaemi reinvents psychohistory as a serious form of scientific inquiry. Along the way, he presents a bounty of startling facts about some of history's great heroes and villains. Under his highly informed and skeptical gaze, our burnished icons—Lincoln and Sherman, Churchill and Hitler, Kennedy and Nixon, and others—are in for some serious resculpting.
—Daniel Dennett, Professor of Philosophy at Tufts University; author of Breaking the Spell, Freedom Evolves, and Darwin's Dangerous Idea

Considered together, and with such rigor and clarity as they are here, these stories are staggering. If so many leaders have suffered so hard, we may well ask: What is 'mental health' anyway? Certainly, we need to reconsider sentimental notions of greatness and heroism. With deft use of biographical and psychiatric detail, Ghaemi exposes a central current of human experience that badly needs this kind of careful and sensitive attention.
—Joshua Wolf Shenk, author of Lincoln's Melancholy

Nassir Ghamei's book is a provocative examination of the link between leadership, depression and mania. It will arouse enormous interest, together with anger and disagreement, and many people will want to read it.
—Paul Johnson, author of Churchill, A History of the American People, and Modern Times

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About the Author

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 trained in psychiatry at, and also serves on the faculty of, Harvard Medical School, and has degrees in history (BA, George Mason University), philosophy (MA, Tufts), and public health (MPH, Harvard). He has published more than a hundred scientific articles and several books on psychiatry. Product Details

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