Monday, January 23, 2012

Newt and "The Goldwater Rule": Why Psychiatrists Will Not Tell You the Obvious

“Newt Gingrich’s three marriages mean he might make a strong president - really,” ran the headline to a Fox News article published last Friday. What else would you expect from the publicity arm of the Republican Party? The twist was the article was written by a psychiatrist, not just any psychiatrist, a psychiatrist employed by Fox News, Fox News’ house psychiatrist Keith Ablow. Dr Ablow also co-authored a book with Glenn Beck and makes a decent living as a celebrity psychiatrist who has appeared on Oprah and other shows.

In his Friday article, Dr Ablow made the extraordinary claim that Newt Gingrich’s marital infidelities might actually make him a better President. The article was a response to allegations from his second wife that surfaced the day before. On Saturday, Gingrich handily won the South Carolina Republican Primary. Wrote Ablow:

When three women want to sign on for life with a man who is now running for president, I worry more about whether we’ll be clamoring for a third Gingrich term, not whether we’ll want to let him go after one.

Ablow also cited Newt’s cold-blooded indifference to his first two wives as a virtue. Really, I am not making this up. In Ablow’s words:

Two women - Mr. Gingrich’s first two wives - have sat down with him while he delivered to them incredibly painful truths: that he no longer loved them as he did before, that he had fallen in love with other women and that he needed to follow his heart, despite the great price he would pay financially and the risk he would be taking with his reputation.

Conclusion: I can only hope Mr. Gingrich will be as direct and unsparing with the Congress, the American people and our allies. If this nation must now move with conviction in the direction of its heart, Newt Gingrich is obviously no stranger to that journey.

Ablow’s article raises a host of issues, the most obvious being why a man speaking as a psychiatrist would be penning such nonsense. Shouldn’t it be the other way around? Shouldn’t we be hearing from a panel of mental health professionals on why Newt is psychologically unfit to hold high office?

The reason you are only hearing journalists and lay commentators ruminating on Newt’s (and other candidates’) putative craziness has to do with psychiatry’s “Goldwater Rule.” Some background:

In 1964, a month before the Presidential election, Fact magazine went to press with this headline: “1,189 Psychiatrists Say Goldwater is Psychologically Unfit to be President!”

The Republican candidate Senator Barry Goldwater of Arizona was a conservative ahead of his time. By 1980, when Reagan swept into office, his ideas were mainstream. By today’s standards, Goldwater would be considered a moderate and on some issues a liberal. By any standard, he was a man of high moral character. Ironically, it was his rival LBJ who would unravel in the Oval Office (see my two posts: Was LBJ Bipolar? The Case For, The Case Against).

Fact magazine sent questionnaires to 12,356 psychiatrists listed by the American Medical Association. Of the 2,417 who replied, 1,189 called him unfit. The eagerness of such a large percentage of its membership to issue summary personal judgments disguised as professional opinions alarmed the powers-that-be to the point that six years later, the American Psychiatric Association issued section 7.3 of its code of ethics that reads in part:

... it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.

The section is only binding on psychiatrists, but clearly psychologists feel constrained by it. The “Goldwater Rule” is why you don’t hear psychiatrists or psychologists stating the obvious: That Newt is a walking-talking DSM-IV Axis II, Cluster B special, displaying a suite of bizarre behaviors distributed along at least three diagnoses, including borderline personality disorder, narcissism, and antisocial personality disorder.

Mind you, as Nassir Ghaemi made abundantly clear in his 2011 book “A First-Rate Madness,” we don’t want our public figures overly normal, either. In certain situations, a bit crazy can be good.

Clearly, the public would be served by hearing an educated discussion on the matter, but the APA does not trust its members enough to restrain themselves. This brings us back to the Ablow’s off-the-wall Fox News piece. Did he breach the Goldwater Rule?

The framers of section 7.3 almost certainly did not foresee the possibility of one of its own employing twisted logic to turn appalling behavior into a character virtue. Had it been the other way around - had another psychiatrist sounding off on MSNBC reached the more obvious conclusion - we would probably hear Fox News screaming for that individual’s head.

That’s how crazy things are.

Much more to come ...


Gina said...

Thank you, John! That part of psychiatric history was unknown to me.

I think I would have to disagree with you about Goldwater. If more had listened to those psychiatrists, they might have seen this early harbinger of the Republican Party becoming completely unhinged.

As for Johnson, well, being the POTUS during a complicated war .... that strains the brain, I would think.

I also completely disagree about Ghaemi and find his work myopic and misguided, at best.

Other than that....... :-)

Thanks John!

John McManamy said...

Hey, Gina. I agree that Goldwater was a harbinger of disaster. He, himself, characterized himself as an extremist, which he saw as a virtue. No doubt about it - he would have been a disaster as President. But if he had any character flaws they weren't readily apparent.

He certainly couldn't be described as a "borderpath," which is clearly the case with Newt.

That leaves an interesting question: Is subscribing to a certain political creed ipso facto a pathology? Back in Goldwater's day, the John Birchers were the lunatic fringe. The Tea Baggers are their descendants. Definite pathologies. No question about it.

But then there are healthy differences in opinion on running an economy and social issues. But moderate conservatives have completely disappeared. The lunatic fringe is setting the agenda. Very scary.

Stay tuned for more blogs ...