A First-Rate Madness (35 page)

Of course, we know what happened to the mentally healthy Richard Nixon, who beat McGovern by a landslide in 1972.

The Eagleton effect, as we might call it, has had long tendrils. The electorate can, it seems, accept mental illness in political spouses (with depression usually: Rosalynn Carter, Kitty Dukakis, Tipper Gore; sometimes with mania: the wife of Florida governor Jeb Bush); but no serious politician has ever admitted even to being depressed. Abraham Lincoln couldn't become president these days, nor could Winston Churchill become prime minister. 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?

We are not there yet. Even the recent election of Barack Obama suggests persistence of the stigma attached to mental illness. He was elected partly because he seems so calm, steady, and unemotional, particularly in contrast to the perceived volatility of John McCain. The candidate was aware of being normal, all too normal: “[Adviser David Axelrod] said to me he wasn't so sure I'd be a good candidate because I was too normal. . . . Axelrod's right. . . . I'm pretty well-adjusted.” “No drama” Obama might be considered the epitome of mental health. We like our presidents moderate and middle-of-the road—psychologically even more than politically. But psychological moderation is not what marks our great presidents. Can we applaud passion, embrace anxiety, accept irritability, appreciate risk-taking, 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.

Atop the list of vices might be the one that most offends our Puritan heritage: sexual indiscretion. This vice is particularly applicable to this book's thesis, since hypersexuality is a common symptom of mania—and a common trait among the leaders we've examined. The impeachment of Bill Clinton over his affair with Monica Lewinsky, a White House intern, brought forth years of pontification on sex and politics. The implication was, for Clinton critics, that a good president had to display “good character”—kindness, moral rectitude, self-control, and so on. “Character above all” became the mantra (the title, for instance, of a PBS broadcast subtitled
An Exploration of Presidential Leadership
). When George W. Bush ran for president, he implied as much when he echoed in his victory speech a note he struck often on the campaign trail: “And so, when I put my hand on the Bible, I will swear to not only uphold the laws of our land, I will swear to uphold the honor and dignity of the office to which I have been elected, so help me God.” Journalist Ronald Kessler titled his sympathetic biography of Bush
A Matter of Character,
and emphasized how Bush's superior behavior made him a better leader than Clinton. Sexuality was always the underlying theme, but Kessler extended his claim to a more general lack of decorum, especially in how the president treated support staff, from cooks and maids to the Secret Service men Kessler interviewed. “With Bush, there was an instant change,” a former Secret Service agent told Kessler. “He was punctual. Clinton was never on time for anything. It was embarrassing. Bush and his wife treated you normally, decently. They had conversations with us. The Clintons were arrogant, standoffish, and paranoid. Everyone got a morale boost with Bush. He was the complete opposite of Clinton.”

I agree with the premise, but not the conclusion. Bush had more sexual continence than Clinton; he may have been better behaved with staff; he may have been more normal and decent. But all that might argue
against,
not for, better leadership skills as a president in time of crisis. Personal vices are, after all, much less of a problem than political shortcomings. As the bumper sticker popular during the Iraq war said, “Nobody died when Clinton lied.”

I am aware this viewpoint goes against conventional morality and the opinion of at least one founding father, John Adams, who famously said, “Public virtue cannot exist in a Nation without private Virtue.” But an excess of virtue is a vice, if we recall that the classical Greek concept of virtue, derived from Aristotle, involved moderation.
Too much
virtue converts courage to recklessness, for instance. It may be legitimate to turn around and flee, rather than fight, under the right circumstances. That's what Aristotle meant by virtue, not some ideal of never-changing steadfastness. Given this perspective, one cannot cleanly separate virtue from vice, for the virtue of courage sometimes involves fighting, sometimes retreating, sometimes charging—each action interpretable as vices of violence, cowardice, and recklessness. Lincoln understood. “It's my experience,” he once said, “that folks who have no vices have generally very few virtues.”

There is a link between this Puritan fusion of private virtue with political leadership and the problem of stigma accompanying mental illness: the insistence on making simplistic Manichean judgments about people's behavior. One is a moral conflation, the other a psychological one. In this book, I am strongly suggesting that political skill on the one hand, and psychological health or even moral merit on the other, are unrelated in most cases, and in some instances may even be inversely related. A “normal” character is not inherently conducive to crisis leadership. In fact, once the benefits of mental illness are appreciated, then we have to accept that “abnormal” personal character traits may indicate better political leadership, irrespective of what our moral beliefs may tell us.

It's not just about sex. As we've seen, the greatest leaders have committed an array of sins. Like alcoholism: Churchill definitely tended toward the extreme there. Or violence: Sherman was darkly savage in many ways. Like dishonesty: King and Kennedy were apparently not open with friends and family about their sexual affairs. Or coldness: Gandhi gave his family little attention or personal sympathy. Or arrogance: FDR had to endure polio before he achieved any measure of humility. Or recklessness: Ted Turner risked his fortune more than once. Some of these sins were unavoidable: hypersexuality and alcoholism, for instance, often arise in those with mood disorders. Other sins were intrinsic to the success of those who commited them. These weaknesses were also strengths.

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 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.

I don't mean to claim that it always takes a disturbed person to have a nuanced and humble view of life and the world. Many probably mentally healthy leaders are also complex and insightful: I would be inclined to include people like Harry Truman, Jimmy Carter and Nelson Mandela on such a list. My claim is that mental illnesses, like depression, do not detract from such abilities, but in fact can enhance them.

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. Being normal is great in a friend and a spouse and in one's daily life; but leaders of nations and armies and businesses are faced with tasks and crises that no one else faces in normal life. For abnormal challenges, abnormal leaders are needed.

We are far from accepting severe depression or mania in our leaders. But there is reason for hope. In 1990, Florida senator Lawton Chiles, running for governor, admitted to depression, which was successfully treated with Prozac. He was elected. Congressman Patrick Kennedy, the last political scion of that great clan, has been entirely open about his bipolar disorder and substance abuse, and he has made the stigma attached to mental illness the focus of his political career.

Stigma is not all or nothing: these days Prozac carries less stigma than ECT, and depression carries less stigma than in the past. But bipolar disorder remains highly stigmatized, and mania sounds scary to many. We have taken a few steps away from stigma, but many more remain to be taken.

 

 

THESE DAYS WE HAVE many more treatments for mental illnesses than we used to. Now we can not only improve but, perhaps more important (as seen with the cases of Hitler and Kennedy), worsen mental illnesses, raising some important questions about how the ideas in this book relate to treatment of conditions like depression and mania.

To be clear, I believe that untreated depression and bipolar disorder can be dangerous and deadly. All patients should be treated, in my view, when their symptoms are severe. Many should be treated even when their symptoms are mild or moderate, or even when they have no symptoms, in the case of conditions like bipolar disorder, where the most effective treatment is prevention of future episodes with mood stabilizers like lithium.

We needn't worry that drugs will deprive mentally ill leaders of the traits that make for great crisis leadership. Frankly, our drugs don't work that well. Most people who take medications still have mood episodes and symptoms; it's just that the medications can make them less frequent or less severe, thus preventing the suicide or psychosis that might otherwise result.

But sometimes, especially with mild depression, we should strive to see beyond the therapeutic imperative, and to realize that life is not all about banishing every symptom. The symptoms of depression might be an inescapable—and sometimes a beneficial—part of life.

This view contradicts the beliefs of many mental health professionals, especially those in the cognitive-behavioral therapy (CBT) school of thought. As I mentioned in the introduction, they believe that depression makes one more unrealistic than normal people. Many mental health professionals, especially psychiatrists, reject depressive realism in favor of CBT. But these perspectives are not necessarily contradictory. 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.

This perspective is still relevant to all kinds of depression, even the more severe kinds. The depressive person isn't at his most realistic when he's in the deep throes of a depressive episode, but rather just before and just after. Beforehand, many people with depressive illness persist at a mildly depressed baseline, not so severe as to diagnose a clinical “major” depressive episode, but also not completely well. Afterward, once the severe episode is over, some people have mild leftover depression, and they can become even more insightful about their lives.

 

 

TOWARD THE END of his life, broke and broken, F. Scott Fitzgerald wrote a letter to his daughter, who was about to go to college, in which he advised her “to form what, for lack of a better phrase, I might call the wise and tragic sense of life. . . . By this I mean the thing that lies behind all great careers, from Shakespeare's to Abraham Lincoln's, and as far back as there are books to read—the sense that life is essentially a cheat and its conditions are those of defeat, and that the redeeming things are not ‘happiness and pleasure' but the deeper satisfactions that come out of struggle.”

For most of us, thankfully, life is not as tragic as it is for those with severe depression. Yet there are lessons for us all in the lives of those whose depression (sometimes aided by mania) spurred them onward to a realistic sense of the world's hazards, empathic concern for others, creative approaches to problems, and the resilience to survive and thrive. Our normal mild self-illusion often serves us well in the course of our daily lives. As Ralph Waldo Emerson said, we need to aim slightly above if we wish to hit the mark. But such normal illusion also hides important realities. 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.

The general approach I take in this book might be called psychological history, an attempt to apply our most scientific current standards in psychology and psychiatry to the study of historical leaders. This approach has its own historical roots in the Freudian “psychohistory” discussed in the introduction, but as described there, my approach is quite different. In this new procedure, one does not “pathologize.” 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. These views are the reverse of stigma-based intuitions of both common sense and previous psychohistories: the “abnormal” is not necessarily a problem; the “normal” is not inherently a benefit. 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. It has its roots in research in psychology and politics that originated with the classic work of the psychologist Hans Eysenck,
The Psychology of Politics,
later developed in the lifelong statistical research of psychologist Dean Keith Simonton, and in recent years advanced by psychologist Drew Westen and cognitive scientist George Lakoff. It recently has begun to influence a minority of professional historians, like Michael Fellman in his biography of Sherman, and journalists like Joshua Shenk in his biography of Lincoln. But many, especially in academia, might still balk at such a new discipline.