Monday, June 28, 2004

Justin Frank's "Bush on the Couch" and the APA Goldwater Rule

Harper Collins, Michael Moore's publisher (curiously, a division of Rupert Murdoch's media empire, something Moore neglected to mention in "Farenheit 9/11") has a new Bush-bashing book out, by a psychiatrist who claims to have psychoanalyzed the President, although he never treated him.

The books is Bush On the Couch: Inside the Mind of the President by Justin A. Frank, M.D

One of our readers emailed us that the American Psychiatric Association prohibits any professional analyst from making a psychiatric judgement without personally examining a patient. He asked if such behavior is unethical.

We looked into the question. Yes, such behavior is unethical.

It is banned not only because it is not scientific, but also because it might cause the entire field of psychoanalysis to be held in disrepute, and perhaps even face legal liability. The APA rule, called the "Goldwater Rule," was adopted after Barry Goldwater sued for libel, when "Fact" magazine published a survey of psychiatrists who said he was crazy in 1964. Goldwater won.

Here is the relevant history from The Politics of Stigma:

"In October 1964, in an effort to discredit presidential nominee Barry Goldwater, the publisher of the now defunct 'Fact' magazine published the results of a survey he had commissioned in which more than 1,189 of the 2,417 psychiatrists answered 'no' to the question, 'Is Barry Goldwater psychologically fit to be President of the United States?' The American Psychiatric Association (APA) and the American Medical Association assailed the survey as 'yellow journalism,' with the APA noting that:

"By attaching the stigma of extreme political partisanship to the psychiatric profession as a whole in the heated climate of the current political campaign, Fact has in effect administered a low blow to all who would advance the treatment and care of the mentally ill of America."

Subsequently, the APA adopted what it called 'the Goldwater Rule' which forbids doctors from offering a psychiatric opinion on a public figure unless the psychiatrist has personally treated the official and has authorization to break patient-doctor confidentiality. Although it is difficult to know with any certainty the effect of any one factor on a political campaign, it appears that the incident contributed to Mr. Goldwater's defeat in the presidential election. He did, however, successfully sue the magazine's publisher, becoming one of the few public figures to win such a libel suit."

Here are some of Frank's psychological findings, as they appear on the Harper-Collins website:

*Bush's false sense of omnipotence, instilled within him during childhood and emboldened by his deep investment in fundamentalist religion

*The president's history of untreated alcohol abuse, and the questions it raises about denial, impairment, and the enabling streak in our culture

*The growing anecdotal evidence that Bush may suffer from dyslexia, ADHD, and other thought disorders

*His comfort living outside the law, defying international law in his presidency as boldly as he once defied DUI statutes and military reporting requirements

*His love-hate relationship with his father, and how it triggered a complex and dangerous mix of feelings including yearning, rivalry, anger, and sadism

Frank concludes: "Bush's rigid and simplistic thought patterns, paranoia, and megalomania -- and how they have driven him to invent adversariesw light on an administration whose record of violence and cruelty seems increasingly dependent on the unstable psyche of the man at its center. Insightful and accessible, courageous and controversial, Bush on the Couch tackles the question no one seems willing to ask: Is our president psychologically fit to run the country?"

It is pretty clear that, if the blurb on the Harper Collins website is accurate, Frank has violated the APA "Goldwater Rule." He is bringing shame on the psychiatric profession by politicizing the psychoanalytic method, in a manner not unlike Soviet psychiatrists who diagnosed political disssidents as insane, in order to lock them up in mental hospitals.

Now the question is: what will the American Psychiatric Association do?

A set of APA ethics rules can be found here.