Bush's irrational consideration of a "surge" in the wake of the ISG report--which apparently defies all credible counsel--has begun to generate speculation regarding his sanity. References to Bush's "delusions" have appeared in the MSM (notable on "Scarborough Country") and throughout the blogosphere. As a psychiatrist, I understandably get concerned when I see clinical terminology bandied about in political discourse, and thought it might be of interest to share my own perspective on this question.
First of all, let me state up front that I probably hate Bush as much (or nearly so) as anybody here. I think he has done more damage to our country than Osama Bin Laden ever did, and probably is the manifestation of OBL's most wicked fantasies following 9/11. Frogmarching him to the Hague (along with Cheney, natch) is too good for him. I think the guy is both stupid and evil, and I have no intention of cutting him any slack here. But in the political/clinical tradition of Dr. Bill Frist's school of diagnostics, I have a distinct clinical impression that I think explains most of his visible pathology.
First and foremost, George W. Bush has a Narcissistic Personality Disorder. What this means, mostly, is that he has rather desperate insecurities about himself, and compensates by constructing a grandiose self-image. Most of his relationships are either mirroring relationships--people who flatter him and reinforce his grandiosity -or idealized self-objects--people that he himself thinks a lot of, and hence feels flattered by his association. Some likely perform both functions. Hence his weakness for sycophants like Harriet Miers, and powerful personalities like Dick Cheney.
Even as a narcissist, Bush knows he isn't a great intellect, and compensates by dismissing the value of intellect altogether. Hence his disses of Gore's bookishness, and any other intellectual that isn't kissing his ass. Bush knows that his greatest personal strength is projecting personal affability, and tries to utilize it even in the most inappropriate settings. That's why he gives impromptu backrubs to the German Chancellor in a diplomatic meeting--he's insecure intellectually, and tries to make everyone into a "buddy" so he can feel more secure. (Pathetic, isn't it?)
The most disturbing aspect about narcissists, however, is their pathological inability to empathize with others, with the exception of those who either mirror them, or whom they idealize. Hence Bush's horrifying insensitivity to the Katrina victims, his callous jokes when visiting grievously injured soldiers, and numerous other instances. The guy simply has no capacity to feel for others in that way. When LBJ was losing Vietnam , he developed a haunted expression that anybody could recognize as indicative of underlying anguish. For all his faults, you just knew he was losing sleep over it. By the same token, we know just as well that Bush isn't losing any sleep over dead American soldiers, to say nothing of dead Iraqis. He didn't exhibit any sign of significant concern until his own political popularity was sliding--because THAT'S something he can definitely feel.
Which brings us to his recent "delusion". To be blunt, I don't see any indication that Bush has any sort of psychotic disorder whatsoever. The lapses in reality-testing that he exhibits are the sort that can be readily explained by his characterological insensitivity to the feelings and perceptions of others, due to his persistently self-centered frame of reference. By applying Occam's Razor to the question of what is psychologically driving Bush to endorse this "surge", I think it can be readily explained by his narcissism as follows. (Warning: Rampant speculation to follow!)
Bush knows that things aren't going his way in Iraq , and he knows that it is damaging him politically. He also sees that it is likely to get worse no matter what he does, and in fact it may be a lost cause. However, he recognizes that if he follows the recommendations of the ISG, that Iraq will almost certainly evolve into a puppet state of Iran , and given his treatment of Iran he will completely lose control of the situation--and he will be politically discredited for this outcome. The ONLY chance that he has to avoid this political disaster, and save his political skin, is to hope against hope for "victory" in Iraq . Advancing the "surge" idea offers Bush two political advantages over following the ISG recommendations. One is that if it is implemented, maybe, just maybe, he can pull out some sort of nominal "victory" out of the situation. The chances are exceedingly slim, granted, but slim is better to him than the alternative (none). Alternately, if the "surge" is politically rejected, he gains some political cover, so when things inevitably go to shit, he can say "I told you so" and blame the "surrender monkeys" for the outcome. Most people probably won't buy it, but some (his core base) will.
Now, I know what many of you are thinking--is George Bush willing to risk the lives of hundreds, maybe thousands more American soldiers, on an outside chance to save his political skin, in a half-baked plan that even he knows probably won't work at all? Damn straight he is. Because George Bush is that narcissistic, that desperate, and yes, that sociopathic as well.
Anyway, that's MY two bits.
Some more thoughts on this: Narcissistic Personality Disorder is frequently associated with alcoholism. The insufferable "holier than thou" attitude associated with "Dry Drunk Syndrome" is indicative of underlying narcissism.
Also, the way that Bush embraces Christianity is characteristically narcissistic. Rather than incorporating the lessons of humility and empathy modeled by Jesus, Bush uses his Christian faith to reinforce his grandiosity. Jesus is his powerful ally, his idealized "buddy" who gives a rubber stamp to any cockamamie invasion he thinks up.
Finally--and this will sound VERY familiar--NPDs are notoriously unable to say they're sorry. Admitting error is fundamentally incompatible with their precarious efforts to maintain their sense of "okayness". Any friend, partner, or family member that has this character flaw almost certainly has NPD.
* Paul L. Minot, MD Inpatient and outpatient general and adolescent psychiatry. Maine General Medical Center , Seton Campus
And he is locked up in that beautiful white house with all those buttons to push.
And I thought Dr. Strangelove was fiction.
3/5/2007
Confirms my opinion of psychiatry that this joker would publish a "diagnosis" for someone he hasn't even met, let alone treated. Got his underlying facts wrong, too.
3/14/2007
Yeah, right. Thank God the Republicans would never do such thing!
Frist Defends Remarks on Schiavo Case
By Charles Babington
Washington Post Staff Writer
Friday, June 17, 2005; Page A17
Bill Frist, the Senate majority leader and a heart surgeon, acknowledged yesterday that Terri Schiavo had suffered devastating brain damage and said his assertion three months ago that she was "not somebody in persistent vegetative state" did not amount to a medical diagnosis.
Frist (R-Tenn.), appearing on three network TV shows, agreed with this week's autopsy conclusion that the Florida woman had suffered severe, irreversible brain damage. "I never, never, on the floor of the Senate, made a diagnosis, nor would I ever do that," he told NBC's "Today" show.
3/15/2007
He should have his license revoked. One does not make a diagnosis on someone they have never met. This Dr's conclusions are reckless at a minimum, and retarded at the maximum.
Not only does his "diagnosis" make no sense, its flat out rediculous.
That is "ridiculous", dear reader. And I am afraid that many of us who actually are capable of following an argument will find this "diagnosis" compelling.
Might one also observe, that those observations are presented in a witty and ironic essay, not delivered as an ad hominem from the floor of the US Senate.
[ed] 3/19/2007
Bumper Stickers
1.) End of an Error
2.) Let's Fix Democracy in This Country First
3.) If You Want a Nation Ruled By Religion, Move to Iran
4.) Bush: Like a Rock. Only Dumber.
5.) If You Can Read This, You're Not Our President
6.) Of Course It Hurts: You're Getting Screwed by an Elephant
7.) George Bush: Creating the Terrorists Our Kids Fight
8.) Impeachment: It's Not Just for Blowjobs Anymore
9.) One Nation, Under Surveillance
10.) They Call Him "W" So He Can Spell It
11.) We Need a President Who's Fluent In At Least One Language
12.) We're Making Enemies Faster Than We Can Kill Them
13.) Is It Vietnam Yet?
14.) You Elected Him. You Deserve Him.
15.) When Bush Took Office, Gas Was $1.46
16.) The Republican Party: Our Bridge to the 11th Century
17.) One Nation Under Clod
3/19/2007
How are all those "normal" American Voters that put him there going to explain themselves to the rest of us.
3/23/2007
To "Confirms my opinion" csn't admit you were wrong about voting for him...twice? You sound like two of a kind.
3/23/2007
As to not being able to diagnose someone you have never met...please, Hitler, Stalin, and on the other end...Abraham Llincoln.
3/23/2007
Psychoanalysis is not necessary; his words and behavior speak volumes which anyone w/o strong political bias can see easily. Listen to your conscience and you will hear it as well.
3/23/2007
Look at his facial features. The same as most FAS (fetal alcohol syndrome)individuals. A common symptom of FAS is the inability to understand consequences. Just a thought.
3/26/2007
I would think that a psychiatric evaluation doesn't necessarily have to be done "in person." Behavioral clues, speech patterns, references etc. are presented via media for evaluation, and a professional with experience would recognize familiar patterns and thus be able to render a general description. We can't tell how much partisanship, in this case, might be present.
I'm no psychiatrist, but I have felt for some time that this President is delusional Can I say fuckin' nuts?
3/29/2007
Say, it dude, say it. Next time, let's not let the supreme fucking court appoint one!
3/29/2007
Bush is definetly a nut case. Dr. Paul Minot does not have to meet the man in person. Any educated person can see that Bush is a narcissist and so is his brother Jeb Bush. Jeb isn't as stupid as George though. Jeb did enough damage to the State of Florida in the 8 years that he was governor. All are happy that he is gone. He was just as stubborn and narcissitic as his big brother. The Dr. has Bush pegged.
Bush is the most damaging thing that has ever happened to the United States. I only wish that all the would be the ones that are going to suffer, loose their homes, good payings jobs, 401K's when this country crashes. We will have a crash unlike the crash of 1929, all because the inept ignorant fucking stupid Americans that helped put this crooked theiving regime in office. Go back to your red-neck single and double wide trailers and make some more ignorant trash. I hope you all starve to death when this country falls apart. Then you will understand what we did to the poor people in Iraq, destroying their lives.
4/3/2007
I'm not a doctor and I don't play one on TV, but I know a school yard bully when I see one. Bush is dangerous especially because his school yard is the world.
4/5/2007
Wonder what disorder the good doctor's furtile mind would come up with if one of the young people that he treats ....(God, the thought of that scares the hell out of me!)... were to tell him: "First of all, let me state up front that I probably hate you as much (or nearly so) as anybody here".
Well, I don't know what Minot would think, but I don't think he would form ANY opinion until having a bit more interaction with his client. (uh, it is fertile, by the way)
In my not very humble opinion, however, if such a statement came from one of our neglected and damaged young vets who have been dealt the shitty hand our VA system is handing out, this would be an indication of rational and appropriate thinking.
Incidentally Abraham Maslow describes such behavior as "psychological security-insecurity". [ed] 4/5/2007
I DON'T THINK THAT IT'S NECESSARY TO HAVE TO INTERVIEW PEOPLE OR EVEN MEET THEM TO MAKE SOME VERY GOOD ASSESSMENTS OF THEIR PERSONALITIES. SURELY YOU'VE HEARD OF PROFILING!!!
4/21/2007
How about blaming the stupid people in the US that not only elected him once, but twice! He wouldn't be there if it wasn't for the majority.
4/24/2007
There is a reasonably plusible argument that meeting a subject offers relatively little in the way of new or substantive diagiostic information. One has only to look at the legions of evaluations that are conducted every year by diagnosticians in correctional settings that miss the mark in either direction by a wide margin.
In this case, Minot is not without some of the most important elements of a sound diagnosis. First and foremost, he has the benefit of seeing the subject operating and behaving in the setting that gives meaning and consequences to both his behavior as well as the likly underlying psychological dynamics.
Many, if not the majority of psychiatric or psychological evaluations occur in a realm that is atypical or unnatural in that they are represent a departure or "time out" from the subject's real world experiences.
In this case, we have a trained clinician looking at behaviors that no one can responsibly ignore or claim to be not accurately described and Minot attributes those behaviors to a particularly well understood pyschological disorder.
That the facts fit the diagnosis is difficult to ignore. That the facts represent behavior that is harmful to this country might easily be dismissed by someone who shares the diagnosis and condition.
Ahhh, bless your prescient heart!!! Thanks.
[ed]
4/26/2007
I just noted that a few words in my comment suffered the effects of excessive finger speed. I thought I'd stipulate to that in anticipation of someone who can't fill in the blanks asserting that all that I wrote should be dismissed simply because of a few mis-typed words.
bborzell
4/26/2007
Not to quibble, but the American people, bless our ignorant souls, didn't really elect him twice. The Supreme Court "elected" him the first time, and the voters, so impressed with Mr. Chimp Goes to Washington, elected him the second time. I'm tempted to start sewing a Canadian maple leaf to my luggage when I go abroad so I don't have to keep wearing that pained, "I'm so sorry" expression on my face.
5/10/2007 That ain't quibbling, my friend! That's a truth. It was a friggin' coup d'etat by the Supremes.
It's down to us against the dimbulbs of JESUSLAND, isn't it.
dlm
5/10/2007
I believe Mr. Minot is telling the truth that our family started telling when Bush called this war. Folks, the Military works for the DOD--- and now they are DOA. Being a Viet Nam Vet I knew instantly that this was another Viet Nam. I was protesting way before it became the thing to do. Where have all the flags gone from the cars, the homes? Unless one has someone over there -- one really doesn't care. Our men and women are losing their lives while most of us sit back on our haunches. I served did you? My Cosuin in Texas sent me a very prolific email recently and I showed it to my retired Navy husgband and he said-- I've been saying this since day one.
One of our neighbors is moving. So I heard the moving van this morning. When I got home I went next door to speak to the 85 year old man. I asked where he was moving too and he said "Back to Germany" I asked if he was going back because he missed it. He said "NO, I'm going back because I've seen this beofre." He explained when he was a kid he watched with his family in fear as Hitler's Government committed atrocity after atrocity and no one was willing to say anything. He said the news refused to question the government, and the ones who did were not in the newspaper business any longer. He said good neighbors, people had known all his life, turned against his family and other Jewe, grabbing on the the hate and superiority "as it they were starved for it" He said he ws too old to see it happen right in fornt of his eyes again, and tool old to do anthing about it, so he was taking his family back to Germany where they would be safe from George W. Bush and his neocons. He seemed resolute, but troubled nevertheless as if his age was wearing on him.In closing he said, "I will pray for your family and your country---
This struck my young cousin very hard-- he has been trying for so long to forwarn people just like so many of have --- when will people listen? When they are led off to the slaughter house? I wonder.
5/13/2007
6/6/2007 301.81 Narcissistic Personality Disorder also would explain why the rules that others must follow never applied to him. I.e. His choice not to show up to his National Guard Duty. NPD's feel that rules do not apply to them as they are special.
8/29/2007
I really watched Bush carefully in this video. The one thing that really struck me is: "He is a man who has been caught in endless serious lies and he is desperate. He will do, he will say, and he will act in ANY WAY to take the focus off of his serious crimes and distract people in another direction.
That is exactly what is going on, on so many levels with this criminal. And criminal he is. Bush and his Administration are the WORST OF THE WORST in the history of the United States, and perhaps, the history of the world.
He knows he is caught and he is trying to wriggle out of it.
But, he can't. Ultimately, he can't.
He is indeed the most dangerous criminal on earth, so is Cheney and the rest of this Administration.
Think about it. Watch him here. Study him. Especially with the knowledge you hold about his actions, his destructiveness, and his lies. It makes sense in a really sick way.
9/16/2007 very interesting
I think you are definitely on the right track
He uses "patriotism" to market his personal agenda, yet feels no real compassion for his dead or maimed "heroes"
74.33.103.116
10/13/2007 David, your comments appear to be a violation of medical ethics. For example see the American Medical Association's Principles of Medical Ethics Section 7:
"3. On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, 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."
218.222.173.131
2/5/2008 I think all those who live in America(I don't thank goodness)...need to tip-toe-around real gentle like...till Nov2008...
Oh! and keep him away from that red button!
122.148.196.207
3/16/2008 Hi , I am impressed with your insight about bushie( no capital b for him) I can take his personality a step further for he is a sociopath as well. Reckless beyond belief and incapable of real emotion only imitated emotion.Read Martha Stout's The Sociopath Next Door for insight on the very personalities runing our country. Keep up the good fight.... Glad you are a smart person
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That ain't quibbling, my friend! That's a truth. It was a friggin' coup d'etat by the Supremes.