This chapter introduces the relationship between mental health and mental illness, paying particular attention to personality disorders. It then identifies narcissism as the most frequent disorder manifesting among political and religious leaders, citing cross-cultural and trans-historical examples of spiritual founders and leaders whose actions strongly suggest that they had the illness. A particularly dramatic example of a contemporary religious narcissist was Bhagwan Shree Rajneesh, and this chapter devotes considerable time exploring his narcissistic doctrines and behaviors, as well as the dire emotional and legal implications that his narcissism had upon his followers. Brief but similar applications of narcissistic personality disorder apply to several televangelists and the founders of both Scientology (L. Ron Hubbard) and the Unification Church (Sun Myung Moon). (The founder of Seventh-day Adventism, Ellen White, probably was not narcissistic but rather was afflicted with histrionic personality disorder.) Rajneesh’s Machiavellianism opened a discussion about his possible dark triad and malignant characteristics, as well as the place that these characteristics play in psychopathic or sociopathic disorders. Within psychiatry, a heated debate has taken place about the differences between these two disorders, but one cult leader who epitomized psychopathy was Charles Manson.