Goldwater Redux

Now it becomes clear: George W. Bush is delusional.

As you know, I am a mental health professional by trade. Prior to the 1964 presidential election, a psychiatrist published an opinion piece in which he stated that candidate Barry Goldwater's favorable disposition towards the use of nuclear (then called "atomic") weapons proved that the Arizona Republican was mentally ill -- dangerously so, in fact. This damning pronouncement, coming as it did with the weight of a clinician's expertise behind it, was credited by some with helping to bring about Goldwater's landslide defeat to the incumbent Lyndon Johnson (who went on to greatly escalate the American military role in Vietnam before refusing the nomination a second time).

The psychiatrist responsible for the opinion piece (and, by extension, the entire psychiatric profession) later came under fire for having had the audacity to render a clinical diagnosis on a public figure whom he had not personally interviewed, with the intent of influencing the outcome of the election. Psychiatry's professional organizations responded by drafting guidelines that later became known as the "Goldwater Rule" -- a general prohibition against offering diagnostic assessments, meant to be taken as clinically valid, on public figures whom the clinician had not actually evaluated in person.

I am here now to brazenly violate that rule, and to tell you that, in my carefully considered clinical opinion, President George W. Bush is dangerously delusional. And I don't just mean "delusional" in the colloquial sense, either; the clinical definition of a delusion reads as follows: a false, fixed belief that cannot be shaken by overwhelming, reality-based evidence to the contrary. By that definition, what else can we call Bush's insistence that the invasion of Iraq was justified, is central to the "war on terror," or is winnable in the conventional sense? There is practically no one anywhere in the world at this point, save for Cheney, Rice, and the new DOD figurehead Gates, who honestly still believes that the invasion of Iraq was not a colossal mistake, has made the U.S. safer, or can be won if we simply increase the number of young Americans being sent to be maimed or killed there.

Don't get me wrong: I'm not suggesting that Bush hears voices in his head (other than the Almighty's), wears aluminum foil hats to keep out the alien rays, or shuffles about the White House mumbling to himself (as far as I know). What I am saying is that Dubya is so deranged characterologically -- what psychiatrists call a personality disorder -- that he is unable to distinguish between reality and his own fantasies, which is a dangerous state of affairs for the leader of the free world.

One of my favorite post-World War II novels was Herman Wouk's The Caine Mutiny, later made into a successful motion picture starring Humphrey Bogart, and then a stage play, in which a decorated Navy ship's captain named Queeg displays increasingly bizarre behavior under stress. Queeg finally comes completely unglued as his destroyer, the USS Caine, threatens to founder in a Pacific typhoon, prompting his first mate to illegally take command. During the court-martial for mutiny, the defense attorney systematically proves that Queeg repeatedly gave commands that reflected his own distorted assessment of the situation rather than the reality of it...but the final blow comes when a Navy psychiatrist who has interviewed Queeg is called to the stand. The good doctor is repeatedly pressured by the defense attorney to put a name to his diagnosis of Queeg's disorder, while insisting that Captain Queeg is "well-compensated." Finally, the tribunal orders the doctor to answer, and he blurts out that Queeg is suffering from a "paranoid personality disorder...but well-compensated." The trial is essentially over at that point; Queeg has been labeled, he's damaged goods. Queeg himself then takes the stand, where he proceeds under cross-examination by the defense to have a complete meltdown. Point, game, and match; the now-pathetic Queeg shambles off the stand, a ruined man.

Bush is not exactly paranoid, but he is narcissistic to an astonishing degree, continually and greatly over-estimating his own capabilities, and dismissing any and all evidence that clearly demonstrates his staggering incompetence. His fantasy, of course, was that he would create a "free Iraq" that would be a Western-friendly state in the middle of the Middle East...one that just happened to sit on the second-largest oil reserve in the world, which he and his oil buddies would then control. Reality would seem to have doomed this rosy view, but Bush won't or can't see that. And we are all the worse off for it.