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February 27, 2007

A Psychiatrist's Analysis of George W. Bush

George Bush's "irrational"consideration of a "surge" in the wake of the Iraq Study Group report -- which apparently defies all credible counsel -- has begun to generate speculation regarding his sanity. References to Bush's "delusions" have appeared in the mainstream media 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 a professional perspective on this question.  I have adistinct clinical impression that I think explains much of Mr. Bush's visible pathology.  First and foremost, George W. Bush has a Narcissistic Personality Disorder.

What this means, 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 with them.  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 who isn't flattering him.  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. 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.  He 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 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.  Mr. Bush knows that things aren't going his way in Iraq, and he knows that this 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 Iraq Study Group, 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 thealternative -- none.  Alternately, if the "surge" is politically rejected, he gains some political cover, so when things inevitably go bad, 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?  Yes, he is.  Because George Bush is that narcissistic, that desperate, and yes, that sociopathic as well.

Especially interesting about Mr. Bush, but quite common, 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 anything he thinks.  Finally -- and this will sound VERYfamiliar to many readers -- those persons with NPD are notoriously unable to say they're sorry.

Admitting error is fundamentally incompatible with their precarious efforts to maintain their sense of order.  Anyone having this particular characterflaw almost certainly has NPD.

This perspective on President Bush's public behavior by Dr. Paul Minot, a psychiatrist in Waterville, Maine, was sent to me in an e-mail from a physician I've known for a long time; I don't know where (or even if) it was originally published and I've never met Doctor Minot; however, googling  his name satisfies me he does exist and probably wrote it. Although I agree with much of what it says and admire its concise, well constructed prose, I'm in profound disagreement with the Psychiatric nosology (system of classification) the evaluation is based on. Sometime soon, I will post a similar evaluation based almost entirely on what I have learned from five years of interviewing people who use cannabis on a regular basis as a way of illustrating where I believe Psychiatry and the Behavioral Sciences have been led astray, with no small assistance from the war on drugs.

Doctor Tom

Posted by tjeffo at February 27, 2007 04:33 PM