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Downing Street BluesReview - Downing Street Blues
A History of Depression and Other Mental Afflictions in British Prime Ministers
by Jonathan Davidson
McFarland, 2010
Review by Chris Vaughan
Jun 14th 2011 (Volume 15, Issue 24)

Seventy one per cent of British Prime Ministers, says Jonathan Davidson, have had mental health issues. Disraeli suffered from depression, Gladstone from bipolar disorder and paraphilia, Lloyd George from depression and somatoform disorder and Churchill from depression and dementia. You would think with such a high casualty rate that the job would come with its own health warning. Except that it is not the stress of office that causes their afflictions as most of them came to office already with an underlying condition. Whether this handicapped or empowered these holders of high office really depended on circumstances and how sagacious they were in coming to terms with their condition.  For many, the exercise of power was all the therapy they needed and being out of power was a time of anxiety, depression and mental anguish.

Professor Davidson has previously analyzed all the US Presidents up to and including Richard Nixon and found fifty per cent with mental disorders. He does not speculate as to why there should be this discrepancy between Britain and the United States. Davidson's analysis of the US Presidency is in essay form. Given the longevity of the Prime Ministerial office and its abundant historiography, his observations are here set out in book form.

He acknowledges that to diagnose people at a distance, reading between the lines of other people's observations, amateur psychologists for the most part, and then putting them through the filter of DSM IV is not ideal but he is convinced given the wealth of biographical material available, patterns of behavior can be discerned that fit the diagnostic categories. 'Good quality biographies offer perceptive accounts of health and mental well-being from which a clinically trained person can often draw conclusions on the medical significance of reported material in a way which the biographer is unable to do.'(p8)

The Office of Prime Minister has a remarkable continuity and stability so is an ideal setting for this kind of study. It is positioned within a set of rules and procedures for the exercise and handing over of power and for changing governments. The book starts with Sir Robert Walpole who was Prime Minister from 1722 till 1745 and finishes with Tony Blair. Every Prime Minister is listed and tagged, the length of their entry depending not so much on their political significance but on the psychological problems they encountered. Edward Heath ( 1970 -- 74) and Harold Wilson (1964 - 1970;1974 - 76) are the last Prime Ministers to receive detailed attention, presumably because biographical material is insufficient with regard to their successors.

In his concluding final chapter Davidson comments on what his findings reveal - some of them surprising. When the figures are totted it up it is quite clear that a significant proportion of Prime Ministers suffered from social anxiety -- which doesn't quite fit the stereotype of a successful politician or those opting for the rough house of democratic politics. Fourteen of the Prime Ministers suffered from some form of anxiety (28 per cent) which is predictable but in eleven of the fourteen it takes the form of social anxiety, double that found in the general population. Davidson surmises that there are three possible explanations for this. Firstly a well-developed sense of empathy which people with SAD often have which in turn could lead to wanting to bring about social reform through a career in politics or secondly, a strong desire to overcompensate for perceived shyness and thirdly in a cocktail of other attributes, social anxiety could manifest as a type of narcissistic personality where even the 'vulnerable-sensitive' type is prone to tendencies to cruelty, bossiness, intolerance, opportunism, arrogance and a demanding manner. (p168)

Given the tendency for all political careers to end in failure -- an observation made by the gifted but divisive twentieth century British politician, Enoch Powell -- and what appears to be a repeating scenario, Prime Ministers becoming more and more beleaguered as their administrations start to unravel, forming kitchen cabinets and seeing conspiracies all around, it is remarkable that paranoia is not more in evidence but Davidson cites only one instance, that of Harold Wilson.

But then there could be a set of psychological disorders peculiar to democratically elected leaders and another set reserved for authoritarian rulers.  Davidson comments that in his study there is 'a preponderance of mood and anxiety disorders and a lack of conditions such as psychopathic  personality, paranoia and even bipolar disorder which are more commonly seen in dictators and autocrats'. (p164) He cites Ludwig who is of the opinion that democratic systems 'nurture the kind of person who is skilled in negotiation and compromise, who knows that elected office is time-limited, that executive power is defined by the constitution and that overall power  comprises a balance between judicial and legislative bodies'.

When Harold MacMillan was once asked what the key was to being a politician, he said, 'Events, dear boy, events!'  The significance of these prime ministerial mental disorders lies in whether they helped or hindered them in dealing with the events of their time in office.  According to Davidson, Britain's disastrous foreign policy and diplomatic performance between the Wars were badly hamstrung by the mental condition of Baldwin, MacDonald and Asquith.

Whereas, in the circumstances of war, what might otherwise have been an awkward debilitating cluster of symptoms, proved triumphantly enabling, for instance, for Winston Churchill. Unfortunately, his alcoholism in all probability led to the subsequent onset of dementia and the abrupt demise of his second term in office. The 'black dog' depression was a major factor in Churchill's make-up and this time Davidson cites an observation of Storr about the circumstances Churchill found himself in, 'If all depressives could be engaged in fighting wicked enemies, they would never suffer from depression. But in day-to-day existence, antagonists are not wicked enough, and depressives suffer form pangs of conscience about their own hostility.' (p164).

Moreover, Davidson positions Churchill on the 'bipolar spectrum' along with five other prime ministerial candidates, who all seemed to thrive in the conditions of national emergency and the call for strong leadership.  'When functioning well, they had abundant energy, self-confidence and dominance, as well as a capacity to make quick decisions and act with authority where necessary.' (p166)

 Thus Davidson does not inevitably regard psychological difficulties in a negative light or as a personal deficiency, especially if they lead to a more realistic assessment of life's complexities. He says that just as mental illness has its own neurobiology, so has wisdom and he cites Gladstone as embodying this very quality. He says that while it would be an obvious error to imply that wisdom and mental illness cannot co-exist, a wise leader, prone to mental disorder and aware of it is more likely to manage his or her episodes of illness with better judgment.(p172) He says that  while Gladstone appears to have suffered from bipolar disorder, he embodied many of the features of wisdom: self-discipline over strong passion(impulsivity), pro-social and altruistic orientation, a moral compass, reflective abilities and self-understanding.(173)  

  To climb the greasy pole of the British system no doubt requires some remarkable gifts but ,as this book shows, these leaders were not supermen but subject to the heartache and the thousand natural shocks that flesh is heir to, and, frequently, faced with situations of extraordinary moment buckled under the pressure.  By treating this historic procession of political leaders with understanding and empathy and making a sober, detached, professional assessment, this book, in my judgment, makes a valuable contribution to grown-up politics.



© 2011 Chris Vaughan




Chris Vaughan writes about himself: I live in Birmingham, England. I am now retired after a career in the pharma industry and am very much involved in community activities. I am a board member of the Birmingham Environmental Partnership and chair a local patient network. I have written a book on the British Health Service and I currently write for a health website. I am very interested in the mind-body.



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