On the media examination of the mental health of political figures

by John Barry
City University

Wouldn’t it be great if we could identify and help people at risk of serious mental health problems before the onset of illness? In fact the British Medical Journal has reported on President George W Bush’s proposal to screen the American population for mental illness (Lenzer, 2004). There are obvious pros and cons to this sort of programme – people of the former USSR will no doubt have fears regarding civil liberties – but it has occurred to me that perhaps the President of the US himself might not be given a clean bill of health, if the claims about his mental health are to be believed.
In the past few years there have been suggestions that George W Bush might not be the epitome of psychological health, and for critics of Bush there is a certain appeal to such claims. During the 1980’s Britain’s Channel 4 television station broadcast Spitting Image, a politically satirical puppet show, that included a storyline called ‘The President’s Brain is Missing’, in which Ronald Reagan’s brain had escaped from his body and was on the run in America (Spitting Image, 1984 –1996). According to the plot Reagan’s body continued through the motions of government, but in a predictably ‘brainless’ fashion. This story was very popular with the British public at that time, though our subsequent knowledge of Reagan’s dementia puts the story in a less comic light.
In recent years some mental health professionals have suggested that there are subtle but worrying signs in the words and behaviour of the current President of the US, George W. Bush. The concerns are various, but the first to receive public attention was the claim that Bush’s words and actions are reminiscent of those of people who are suffering from what known in Alcoholics Anonymous circles as ‘dry drunk syndrome’. This observation was first made by political journalist Alan Bisport (2002). Bisport suggested that although Bush had ended 20 years of heavy drinking in 1986 after being “rescued by God” (Bisport 2002, para.5), alcoholism had left Bush with permanent cognitive limitations. Professor of Social Work and author on addiction treatment Karen van Wormer amplified this view, asserting that the pattern of thinking shown by Bush is often identified in recovering alcoholics attending Alcoholics Anonymous or substance abuse counselling. The ‘dry drunk’ is someone who exhibits the following symptoms: van Wormer suggests that Bush exhibits all of these traits apart from the first (being the President of the most powerful country in the world leaves little room for the exaggeration of your importance!). She cites several examples from his speeches to illustrate. For example, regarding his rigid & judgmental outlook, she cites his comments regarding attacks against Israel: “…look my job isn’t to try to nuance. I think moral clarity is important… this is evil versus good” (ITV, 2002). van Wormer gives an illustration of the trait of impatience shown by Bush regarding needing proof of Iraq possessing weapons of mass destruction before war was waged: “If we wait for threats to fully materialize, we will have waited too long” (Office of the Press Secretary 2002, para 18). Erosions of freedom of speech under the Bush administration (Reilly, 2004) probably straddle several of the above symptoms, but as we know science does not progress simply by searching out instances supporting our hypotheses, but by instances that contradict our hypotheses. If we are to ‘diagnose’ Bush on the basis of interviews and speeches we need only one instance of a time when he has shown patience or an ability for being flexible & non-judgemental for the entire ‘diagnosis’ to require reassessment.
However, another explanation is that the rigidity of thinking etc are simply part of the conservative mindset, a mindset shared with Bush by all who voted for him. In their meta-analysis of 88 samples from a wide range of sources (including experimental studies, surveys, and statements by politicians), Jost et al. (2003) found that political conservatism is related to several psychological variables including: death anxiety (r = .5); system instability (r = .47); dogmatism–intolerance of ambiguity (r = .34); openness to experience (r = –.32); uncertainty tolerance (r = –.27); and needs for order, structure, and closure (.26). They give an example of dogmatism-intolerance of ambiguity from George W Bush: “I know what I believe and I believe what I believe is right” (Sanger, 2001, cited in Jost et al. 2003, p.353). However, such traits are not necessarily fixed, and can be influenced by events. Regarding ‘death anxiety’: “High profile terrorist attacks such as those of September 11, 2001, might simultaneously increase the cognitive accessibility of death and the appeal of political conservatism” (Jost et al. 2003, p.364). This might go some way to explaining the appeal of conservatism to US voters, and could imply that – ironically – the more salient death is made as a result of the backlash against US conservative foreign policy, the more likely voters are likely to be frightened into supporting the very policies that have provoked such dangers. Jost et al’s work implies that people are politically conservative for different reasons, perhaps some due to nature and others due to nurture, so even if Bush were suffering from an organic cognitive impairment his condition might be ameliorated by his environment. Is everyone who voted for Bush a dry drunk? Obviously not, despite the fact that they may share similarities in cognitive style.
Another attack on Bush’s mental credibility comes from Justin Frank, Director of Psychiatry at George Washington University. In his book Bush on the Couch: Inside the Mind of the President he agrees with Bisport’s and van Wormer’s view that alcoholism may have left Bush with a tendency to black & white thinking, but Franks goes much further. Using the technique of ‘applied psychoanalysis’ to assess Bush (without ever actually meeting him) the picture Frank paints of a young boy scarred by the death of his younger sister seems only tangentially relevant to the actions of George W Bush, the adult and President. Frank’s method of assessment has been used by the CIA to profile foreign leaders though autobiographical sketches, and clearly falls short of the DSM in terms of diagnostic validity.
In conclusion, why do we need to argue that someone whose opinions and actions are ones we disapprove of is necessarily insane? Other leaders have had drug or alcohol problems (e.g. J.F. Kennedy) or mental health issues (e.g. Winston Churchill) and this has not stopped them from being great leaders. The tendency to pathologise everyday behaviour is an impulse we need to curb; sometimes a excitable and energetic child is just that, and not a case of ADHD in need of urgent treatment. As for Bush, perhaps in the end it is just more comfortable to think that his behaviour couldn’t be that of someone sane, as it implies that we all might behave in that way if they were in the same situation.
It is obvious that attempting diagnosis without having direct access to the patient has its limitations and dangers. On the other hand, while we were laughing at Spitting Image’s portrayal of a bumbling and forgetful Reagan in the 80’s, little did we realise that these public gaffs were likely to have been the early signs of Alzheimer’s. But in the end, mental illness is no laughing matter, nor a matter for political point-scoring.

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The editorial expresses the opinion of the author and does not represent the views of the Editorial Team.