A First-Rate Madness (27 page)

In sum, Hitler was constantly taking three kinds of psychoactive drugs: opiates, barbiturates, and amphetamines, of which the amphetamine use was most potent since it was given both intravenously and orally. We don't know how much intramuscular anabolic steroids (from the ground-up bull testes, prostate, and adrenal glands) were given, but it is plausible that (like John Kennedy in 1961–1962) Hitler also received anabolic steroids regularly. Kennedy's doctors were able to get his psychopharmacological mix under control after banishing his quack Dr. Jacobsen; Hitler's doctors were never able to oust Morell. If Kennedy's mix eventually became a “spectacular psychochemical success,” Hitler's was a much more spectacular disaster.

 

 

GIVING AMPHETAMINES every day, intravenously, to a man with untreated bipolar disorder is likely to have a grave effect on his decisionmaking processes. Even oral amphetamines, being powerful antidepressants, cause mania in about half of people with bipolar disorder, especially if mood stabilizers like lithium (which weren't available in Hitler's time) aren't given as well. If such is the case with oral amphetamines that are less potent than what Hitler took, then the chances someone with bipolar disorder would become manic with
intravenous
amphetamine are much higher than 50 percent, so high that we can't even test the notion: no contemporary hospital ethics committee would ever allow such a risky study; it would be blatant abuse of patients' rights. Yet Adolf Hitler took such abuse every day. Rats treated this way, with daily intramuscular amphetamine for months, are used as an animal model of psychosis. In sum, these are dangerous drugs, especially when given to people with severe mental illnesses.

Hitler had relatively severe bipolar disorder, like Churchill or Sherman; but unlike them, he received daily intravenous amphetamine treatment for the last four years of his life, supplemented with oral amphetamines and caffeine (and mixed with consistent barbiturates and opiates, and intermittent anabolic steroids). A normal person would have a tough time remaining sane with this concoction. (In contrast, Churchill's amphetamines came only in pill form, and not consistently. Kennedy never received intravenous injections of steroids, to our knowledge, only intramuscular, and he did not have full-blown bipolar disorder, but hyperthymic personality, which would make him less susceptible to mania or psychosis. Also, his amphetamines were always oral and low-dose.) To call Hitler a time bomb would be to understate matters. Morell lit a fuse that exploded the entire world.

Hitler changed in those final years in many ways. Though he had always been an angry man, especially when manic, he had been generally courteous and proper in social settings, able to exercise good self-control when needed. But by 1942 he routinely screamed at generals during military meetings. Many observers noted that his rages were much worse than they had been in the 1930s. On one occasion in December 1942, he shouted nonstop for three hours. That anger was not limited to military matters. Once, for instance, after the death of an opera singer (Hitler loved opera), he was indignant at what he thought was insufficient newspaper coverage and exploded in “a frenzy of rage against the press. His fury lasted for hours and made him literally incapable of work for the rest of the day.” By December 1943, Himmler, convinced that Hitler had a “sick mind,” disobeyed some orders, such as one to execute all prisoners of war. On at least two occasions (in 1938 and 1942) several generals tried to persuade prominent psychiatrists to commit Hitler to a mental asylum. (The doctors refused.)

Speer notes that whereas Hitler used to ask intelligent questions of his generals and then listen to their responses, the Führer increasingly refused to listen to anyone. “No retreat” became his mantra, whatever the specific military circumstances. For instance, Hitler previously had enjoyed reports of General Erwin Rommel's successes in North Africa, especially his tactic of the “fighting retreat and counterattack.” But in November 1942, in the great battle of El Alamein, Hitler refused to allow Rommel to move his troops as he wished; no retreat, came the orders. Rommel was demolished. On July 20, 1944, military plotters failed in their attempt to bomb Hitler. Some of the plotters eventually confessed that Rommel was an ally, and as Hitler tracked down and executed officers implicated in the plot, Rommel concluded that his Führer was insane. (“That pathological liar has gone completely mad!” he told an aide.) By October, the regime gave Rommel two options: quietly commit suicide or be executed along with his family. The Nazis said he had died of a heart attack, and arranged a solemn burial with full military honors.

 

 

EARLIER IN HIS CAREER, Hitler had no trouble delegating authority. He set broad policies and let his domestic and military advisers enact them. Now he became obsessed with details, telling his commanders what to do at every turn. No order could be given without Hitler's specific approval. Said Field Marshal von Rundstedt, “The only troops I could move without permission were the sentries outside my door.” Here too amphetamines may be relevant. Hitler likely had, as previously noted, obsessive tendencies, reflected in his fixation on personal hygiene and cleanliness. This trait may have worsened with amphetamine use, which is well known to cause or worsen symptoms of obsessive-compulsive disorder.

While he was taking amphetamines, Hitler's moods cycled more quickly and severely than before. When he was depressed, he slept longer, refusing to talk about the war as much as possible. He ate alone, he couldn't concentrate, he was indecisive, and, unusually for a man famous for his great memory, he was absentminded. In 1943, Morell even publicly revised his prior diagnosis from (only) depression to manic depression. Morell was no psychiatric expert, but he was correct if he truly said and meant this. (The source for this citation is from a contemporary book by a Swedish journalist.) Morell intensified the amphetamine treatments, which probably only worsened Hitler's mania. Speer reports that from then onward, Hitler never seemed depressed again until the final days in the Berlin bunker. Instead, he was increasingly unrealistic and overoptimistic: “The more inexorably events moved towards catastrophe, the more inflexible he became, the more rigidly convinced that everything he decided on was right.” Linge, Hitler's valet, told the Hestons that this was correct, except that Hitler had brief depressive periods, usually lasting days to weeks, when he would get tearful and wish that he would die. The Hestons date such brief periods to August 1944, February 1945, and again at the end of Hitler's life in April 1945. It is probable that the extensive intravenous amphetamine injections, perhaps augmented by steroids, were causing Hitler to “cycle” into and out of his manic and depressive episodes more and more quickly. In his final two years, Hitler probably never experienced a day of normal mood.

His world was collapsing; his mind already had.

 

 

WAS HITLER PSYCHOTIC? That is, did he have hallucinations or delusions? This question is worth considering because it reflects a common assumption among both historians and the rest of us. As noted above, it's natural to believe that atrocities as extreme as Hitler's could only be the products of a thoroughly deranged mind—one that has abandoned reality and inhabits an unreal world of delusion and hallucination. This assumption is bolstered in Hitler's case by some evidence that could be viewed as indicative of psychosis.

Hearing voices (auditory hallucination) is one symptom of psychosis, and in 1918, when he was in a military hospital, Hitler heard a voice telling him that he was to be Germany's savior. (Some think his experience occurred under hypnotic suggestion, and that he actually was hearing the voice of his psychiatrist, Dr. Edmund Forster.) Throughout his career, Hitler frequently spoke of following his “inner voice”; but then again, so did Gandhi. Using the word “voice” metaphorically is not the same as hearing an actual voice. During World War II, Hitler claimed to hear orders from God, but such voices were less likely the result of inborn psychosis than years of IV amphetamine use.

As for delusions, psychiatrists sometimes define them as involving fixed false beliefs held against incontrovertible evidence to the contrary, with markedly illogical thought processes. For instance, I might believe the world will end tomorrow because Martians have begun to eat my entrails. That is a clear delusion. But Hitler's extreme anti-Semitism is not delusional, partly because he belonged to a culture where anti-Semitism was hardly unusual. Such an attitude was undoubtedly wrong—both morally and factually—but it was common enough to fall within the realm of normal behavior for Hitler's time. And while he was paranoid toward a world of enemies, his paranoia wasn't necessarily delusional, because he in fact had many enemies. He was paranoid about the German military, but that was not irrational, because German generals repeatedly tried to remove him from power. He had grandiose ideas. He thought he alone would save Germany, but this was not a delusion: many other people thought he could too. He also had a constant phobia about syphilis, fearing that he might have contracted it. But he had many obsessions, including a strong desire to be clean and a fear of germs. This abnormal thinking is more consistent with obsessions than delusions. Toward the end of World War II, he may have had delusions; he was known to issue orders to nonexistent armies. But again, by then he'd been taking intravenous amphetamines for several years, which alone or in combination with his underlying bipolar disorder could produce delusions.

So Hitler wasn't just plain crazy, in the sense of outright psychosis, though he may have been made crazy by a nightmarish mixture of drugs and mania.

AS I DISCOVERED, the literature on Hitler's psychiatric condition is immense, and it offers up a welter of theories about his mental state. We should examine those theories in light of the evidence we've gleaned about his symptoms and drug use.

The most common psychiatric diagnosis given to Hitler is antisocial personality disorder, but this condition involves such features as cruelty to animals, breaking the law, and complete absence of empathy. Yet Hitler loved animals, never broke the law before his political activities, and clearly had much empathy for his mother, his childhood friend Kubizek, his half niece Geli, and others. Other personality disorders, such as borderline personality, also don't correspond with Hitler's life. (There is no evidence he was sexually abused, for instance, and he never cut himself or otherwise attempted suicide before his death—all of which are cardinal features of borderline personality.)

We also can put aside the myriad psychoanalytic histories, for reasons given earlier in this book. Calling Hitler a “paranoid destructive prophet,” a typical psychoanalytic diagnosis, fails to clarify his condition or explain his actions. He was paranoid, yes, but that was likely the result of mania and depression rather than unprovable speculations that his father beat him too much or his mother loved him too much. Psychohistory has been rightly rejected by historians on both sides of the Hitler debate—those (like Alan Bullock) who view him as a politically skilled scapegrace who was simply evil, and those (like Hugh Trevor-Roper) who view him as an ideologue who, while certainly evil, believed he was doing good. But rejecting psychoanalytic diagnoses shouldn't prompt us to ignore his clear manic and depressive episodes.

Hitler certainly had many anxiety symptoms (high neuroticism) and obsessions, and he probably experienced post-traumatic stress disorder (PTSD) from World War I, for which he may have received his only official psychiatric treatment in his entire life. This is a controversial topic, because Hitler and the Nazis went to great lengths to deny or try to cover up any documentary evidence that he might have had mental illness. When he was hospitalized at the end of World War I, he claimed he had gone temporarily blind from mustard gas. It seems more likely he had hysterical blindness, a kind of PTSD, and he apparently was treated by the psychiatrist Dr. Edmund Forster, with a kind of hypnotic suggestion. Forster apparently later felt guilty, believing that he may have accidentally inspired Hitler's megalomania; there is some evidence that Forster may have given Hitler's psychiatric records to German exiles in a 1933 Paris meeting, after which he committed suicide or was killed. U.S. intelligence records document this possible scenario, as do some recent researchers who interviewed people who knew Forster. Researchers who have studied Hitler's probable PTSD have drawn simplistic conclusions, however, such as the notion that this condition may have somehow “invented” the Führer—transforming him from a harmless apolitical artist to the grandiose anti-Semitic despot. But, as discussed in chapter 9, PTSD doesn't just occur in a vacuum; one's preexisting personality traits greatly influence one's likelihood of suffering this disorder. Although Hitler likely had PTSD, he also had plenty of mood episodes before the First World War that more cogently prefigure his behavior and actions later in life.