While sorting book donations to our theological library at the Community of St. Mary, I came across a recently published book with a strange title: A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness. I read a lot of strategic leadership books in my MBA days, so I wanted to see what the pop psychologists are saying.[1] Dr. Nassir Ghaemi would have us reevaluate what he considers our provincial thinking about mental illness and health. His motivation for suggesting this is to avoid the stigmatization of the mentally ill, just as we should with terms of racism, sexism, tribalism, etc. He contends that “we stigmatize those who differ from us.”[2]

The question arises, though: Is that a valid comparison? Is defining “mental illness” simply a matter of mental perspective and imagination?

Back in 2011, Dr. Ghaemi’s thesis did not impress Janet Maslin, reviewer for The New York Times, nor Kirkus Reviews, which helps new authors get published:

The author demonstrates his scary thesis by thumbnail psycho-biographies of successful troubled leaders and a few flops who were, apparently, quite normal. In hard times, good politics are bipartisan and great politicians are bipolar. The depressed see life realistically, and the deranged are creative. … A diseased mind, Ghaemi candidly admits, attracts stigma, but he insists that the essence of mental illness promotes crisis leadership. A diverting, exceedingly provocative argument — sure to attract both skeptical and convinced attention.


I have to agree with them, but probably for different reasons. Dr. Ghaemi says it very neatly himself:

Health is diagnosed all the time, but it is seen to have limitations that are unhelpful. Illness, on the other hand, when present, is often helpful. … The new psychological history, for the first time, tries to get beyond stigma, consciously and clearly. … This new approach is scientific, not hypothetical; empirical, not theoretical.[3]

His last sentence has a wonderful cadence to it — “scientific, not hypothetical; empirical, not theoretical” — but it is a little too pat. He is falling into the common Western amnesia since John Locke and David Hume that “empirical” means “real” and anything that is not empirical is unreal. To confuse things further, “scientific” now bears the weight of meaning “real,” instead of “the search for validating a humanly devised hypothesis.” And “hypothetical” has come to mean “unreal” rather than having the humble freedom of man searching for the greater “real” that we might call God.

Herbert Butterfield (1900-79), once Regius Professor of Modern History at Cambridge, claimed in The Origins of Modern Science that the discipline evolved from philosophy during the Renaissance. Yet the search for truth was not such a late development. Maximus the Confessor staked his classically educated life as a monk on the principle that knowing truth is the ultimate state of divinization.[4] Who among us would claim that knowledge except the perfect Man? We dodge the bullet in our Western culture by allowing the nominalistic “your truth may not necessarily be my truth” stand rather than submit our knowledge to God’s truth and wisdom by acknowledging our covenant relationship with God “in Christ” (Gal. 3:26-28; Phil. 1:1).

Now we have psychological history in which “Health is diagnosed all the time, but it is seen to have limitations that are unhelpful [and] [i]llness, on the other hand, when present, is often helpful.” In less than a hundred years, popular culture has buried the discernment of wisdom needed to know the difference between health and wholeness, disease and illusion. Rather than seeking wisdom beyond ourselves, we have the “Goldilocks principle.”

As with illusion—where the Goldilocks principle suggests that some is good and none or too much is bad—so it may be with depression. Some of it enhances realism, but none at all, or too much, may lead to distorted, illusory thinking.[5]

Our grandparents would have met crises in life as circumstances that God would allow for their growth in maturity. Now Dr. Ghaemi would explain them differently:

When the crises of daily life come, we realize that we had been living a forgetful life, unaware of some basic truths. Then some depression may help us see what has happened and what we must do. And then we might be able to meet the challenges of life, and maybe even attain some happiness in the process.

Quite a paradox it is: being open to some depression may allow us, ultimately, to be less depressed.[6]

And there lies the rub. I found nothing in this book that uncovers any links between leadership and mental illness. I found a lot of anecdotal evidence showing how leaders overcame extremely adverse circumstances through resilience and tenacity, whether it was a depressed Winston Churchill versus Adolf Hitler or a hyperthemic (defined as “always upbeat, outgoing, high in energy”)[7] sufferer of Addison’s disease, John F. Kennedy, versus Nikita Khrushchev.


Emma Donoghue describes well in her novel Room how five-year-old Jack, growing up in an 11-by-11-foot room with only a television, thought people were flat two-dimensional figures who moved and talked on the screen but had no connection to him. Just as Jack had to make a major adjustment to life in the real world after his experience in “the room in the backyard,” so Dr. Ghaemi would have us consider a different perspective and attitude concerning people with mental illness.

In our world of three dimensions, time and space on earth, are we not comparable to
Jack in Room? Do we not fall victim to hubris and provincial thinking when we think what we think is the norm? Science alone seems all so gray with no possibility of being Surprised by Joy, as C.S. Lewis described his thought explorations of literature and philosophy; he eventually became so unhappy and depressed that he was willing to listen to another dimension to his life through revelation. Augustine of Hippo describes a similar point in his life in Confessions. Sitting in a garden in Rome, he heard a voice (nowhere to be seem) that said, “Take up and read.”

So was I speaking and weeping in the most bitter contrition of my heart, when, lo! I heard from a neighbouring house a voice, as of a boy or girl, I know not, chanting, and oft repeating, “Take up and read; Take up and read.”  Instantly, my countenance altered, I began to think most intently whether children were wont in any kind of play to sing such words: nor could I remember ever to have heard the like. So checking the torrent of my tears, I arose; interpreting it to be no other than a command from God to open the book, and read the first chapter I should find. For I had heard of Antony, that coming in during the reading of the Gospel, he received the admonition, as if what was being read was spoken to him: Go, sell all that thou hast, and give to the poor, and thou shalt have treasure in heaven, and come and follow me: and by such oracle he was forthwith converted unto Thee. Eagerly then I returned to the place where Alypius was sitting; for there had I laid the volume of the Apostle when I arose thence. I seized, opened, and in silence read that section on which my eyes first fell: Not in rioting and drunkenness, not in chambering and wantonness, not in strife and envying; but put ye on the Lord Jesus Christ, and make not provision for the flesh, in concupiscence. No further would I read; nor needed I: for instantly at the end of this sentence, by a light as it were of serenity infused into my heart, all the darkness of doubt vanished away. (Augustine, Confessions 8.12)

Perhaps, instead of focusing so much within our own minds, and the illnesses or lack thereof, we should follow Lewis and Augustine and stretch our focus to the horizon revealed beyond us.


[1] Emma Donoghue, Room (MacMillan Publishers Ltd, 2011).

[2] Nassir Ghaemi, A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness (The Penguin Press, 2011), p 262.

[3] Ibid., p. 266.

[4] Maximus, Ambigua 10 [1113 BC], as translated by Nicholas Constas. “For they say that God and man are paradigms of each other, so that as much as man, enabled by love, has divinized himself for God, to that same extent God is humanized for man by His love for mankind; and as much as man has manifested God who is invisible by nature through the virtues, [1113C] to that same extent man is rapt by God in mind to the unknowable.”

[5] Ghaemi, A First-Rate Madness, p. 264.

[6] Ibid, p. 265.

[7] Ibid., p. 16.

About The Author

Mother Miriam, CSM is the ninth Mother Superior of the Eastern Province of the Community of Saint Mary.

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