SOCIOPATHY AND ITS DISCONTENTS: Sociopathy and its willing enablers!

MONDAY, OCTOBER 5, 2020

Sociopathy on steroids and stilts: For many years—for almost five decades—the so-called "Goldwater rule" was a very good rule. It seemed to make lots of sense.

We speak here of journalistic practice, though the so-called rule came into being as a stricture on psychiatrists and psychologists. 

The rule was adopted in reaction to reckless punditry during the 1964 White House campaign. The leading authority on the rule offers the following thumbnail:

The Goldwater rule is Section 7 in the American Psychiatric Association's (APA) Principles of Medical Ethics, which states that it is unethical for psychiatrists to give a professional opinion about public figures whom they have not examined in person, and from whom they have not obtained consent to discuss their mental health in public statements It is named after former US Senator and 1964 presidential candidate Barry Goldwater.

The issue arose in 1964 when Fact published "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." The magazine polled psychiatrists about US Senator Barry Goldwater and whether he was fit to be president. Goldwater sued magazine editor Ralph Ginzburg and managing editor Warren Boroson, and in Goldwater v. Ginzburg (July 1969) received damages totaling $75,000 ($523,000 today).

In the literal sense, the Goldwater rule offers professional guidance to medical personnel. Continuing, the leading authority even provides its text:

Section 7, which appeared in the first edition of the American Psychiatric Association's (APA) Principles of Medical Ethics in 1973 and is still in effect as of 2018, says:

"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."

According to the text of the rule,  "it is unethical for a psychiatrist to offer a professional opinion [of a political figure or candidate] unless he or she has conducted an examination and has been granted proper authorization for such a statement." 

That rule provided explicit guidance to psychiatrists. The spirit of the rule was widely adopted within the upper-end press corps, though it was sometimes honored in the breach).

(The late Charles Krauthammer, a psychiatrist as well as a Washington Post columnist, often psychoanalyzed Democratic politicians for the Fox News Channel. Because Krauthammer was a major insider, few people ever complained)

For decades, this rule provided a very good rule of thumb for journalists. It remained a very good rule until it suddenly wasn't. 

It ceased to be a very good rule when it became fairly obvious that the president of the United States might be suffering from a major psychiatric disorder. At this point, this very good rule became a stranglehold on informative public discourse.

Is Donald J. Trump a "sociopath?" We can't tell you that. 

(If he is, we've often said that this should be a source of pity and of concern, not a source of loathing.)

As we understand it, that term doesn't even appear within any approved diagnosis within the current DSM. Again, we turn to the leading authority for an overview:

Antisocial personality disorder (ASPD or APD) is a personality disorder characterized by a long-term pattern of disregard for, or violation of, the rights of others. A low moral sense or conscience is often apparent, as well as a history of crime, legal problems, or impulsive and aggressive behavior.

Antisocial personality disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Dissocial personality disorder (DPD), a similar or equivalent concept, is defined in the International Statistical Classification of Diseases and Related Health Problems (ICD), which includes antisocial personality disorder in the diagnosis. Both manuals provide similar criteria for diagnosing the disorder. Both have also stated that their diagnoses have been referred to, or include what is referred to, as psychopathy or sociopathy, but distinctions have been made between the conceptualizations of antisocial personality disorder and psychopathy, with many researchers arguing that psychopathy is a disorder that overlaps with, but is distinguishable from, ASPD.

At present, the technical diagnosis would apparently be "antisocial personality disorder." Others have suggested the possible current relevance of another official disorder, "narcissistic personality disorder."

In colloquial terms, is it possible that Donald J. Trump is a "sociopath?" 

In part because the upper-end press corps refuses to discuss any such topic, we rubes are often inclined to think that sociopathy is a "one in ten million" occurrence—a disorder afflicting the Hannibal Lecters (or the Ted Bundys) of the real or the fictional worlds.

That doesn't seem to be the way it works. Two years ago, an article in Psychology Today offered this basic background:

EDDY (4/30/18): In 1994, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders was published (the DSM-IV). It stated that estimates of the prevalence of Narcissistic Personality Disorder (NPD) were “less than 1% in the general population.” Regarding sociopaths (the DSM uses the equivalent term Antisocial Personality Disorder or ASPD), it said that overall prevalence “in community samples is about 3% in males and 1% in females.”

Between 2001 and 2005, the National Institutes of Health (NIH) funded the largest study ever done regarding the prevalence of personality disorders in the United States. Structured interviews were done with approximately 35,000 people who were randomly selected to be representative of the U.S. adult population in a variety of ways including age, income, gender and region. This study found that 6.2% of the general population would meet the criteria for NPD3 and 3.7% would meet the criteria for ASPD (5.5% male and 1.9% female).

Say what? Among adult American males, 5.5% "would meet the criteria for" diagnosis as a "sociopath?" 

What could that finding possibly mean?  Because our upper-end, mainstream press corps refuses to conduct such discussions, you've never seen any such question discussed. 

Instead, our press corps focuses on whatever Donald J. Trump said or tweeted ten minutes ago. Journalists then speculate about how that statement or tweet might affect future polls of [INSERT NAME OF DEMOGRAPPHIC GROUP] in [INSERT NAME OF SWING STATE].

That's the way our upper-end press corps actually functions. Several centuries after the Age of Enlightenment is routinely said to have swept through Europe, that's what our upper-end press corps typically says and does.

We've outlined all this material before. It becomes especially relevant today because of some recent behaviors. We list those behaviors here:

We refer to President Trump's recent car ride with two endangered Secret Service agents.

We refer to the behavior of the president's family and top advisers at last Tuesday's "debate."

We refer to the bizarre behavior of attendees at the earlier reception for Amy Coney Barrett—first in the Rose Garden, then inside the White House. 

We refer to the peculiar behavior of Dr. Sean Conley in his recent statements about the president's health. In fairness, Conley may be caught between a disordered person and a hard place.

We refers to Jason Miller's gruesome non-discussion discussion with Ana Cabrera on CNN last night. 

We even refer to the hard tribal thinking of the everyday Trump supporters quoted in this Washington Post report. (We hasten to say that our own tribe has engaged in disordered thinking about various topics and events over the past, let's say,  eight years.)

These incidents raise the basic question of human functioning and its discontents. These  incidents raise questions of psychiatric disorder, but of cognitive disorder as well.

At this point, we'll offer a partial definition of primitive thinking. In part, primitive thinking is that type of cogitation in which a person refuses to accept or consider a new analysis, framework of possibility even in the face of overwhelming evidence.

So it has been as the upper-end press corps has clung to its version of the Goldwater rule. This primitive thinking has prevailed across this upper-end guild, and it has continued right to this very day.

This morning, at 7:24 A.M. Eastern, we saw a striking exchange between Joe Scarborough and Robert Woodward. We haven't yet seen any videotape, but the exchange went almost exactly like this:

SCARBOROUGH (10/5/20): We say he's a sociopath. It's beyond that [now].

WOODWARD: Well, we're not psychiatrists. All we can do is describe the behavior.

Except that isn't all they can do. They can also do this:

They can speak to (carefully selected) people who actually are psychiatrists. They can ask these (carefully selected) people what the behaviors listed above may suggest to them.

That's what people like Woodward do in every other technical field. Imagine if a major journalist ever said something like this:

"Well, we're not doctors or medical experts. All we can do is describe the 200,000 deaths."

Journalists aren't supposed to be "experts." They're supposed to know how to glean information from (carefully selected) people who are.

In its journalistic applications, the Goldwater rule was a very good rule for a very long time. 

Consider the ridiculous way our nation's top pundits have analyzed bald spots and earth tones, not to mention Candidate Obama's possibly disqualifying lack of weight. For decades, the Goldwater rule tended to keep these manifestly incompetent people from wandering even farther afield.

In the ideal sense, the Goldwater rule ceased to be helpful when it came to be that we had a commander who rather plainly seemed to be some version of mentally ill. At that point, the press corps' refusal to speak with medical experts began to resemble the refusal of earlier, more "primitive" people to accept such obvious facts as the fact that the Inka was dead.

What is human functioning actually like? How do we tend to react when long-established analytical frameworks suddenly cease to be helpful?

What's our intellectual functioning like? How about our emotional functioning? It's within the context of those questions that we'll be typing this week. 

We'll be discussing a possible major disorder and its willing enablers. For today, though, make no mistake:

When Donald J. Trump got into that car with those Secret Service agents, an obvious possibility became obvious once again. Disconsolate experts told us two things:

They told us that the commander's conduct looked a bit like sociopathy on steroids. Figuratively, they described his behavior as  "sociopathy on stilts."

The lives of two agents were placed in danger. The upper-end band played on.

Later today: Nicholas Kristof gets it right concerning the ongoing state of the pandemic. 

Also, we'll recall the death of the Inka. Anthropologists continue to claim that this past behavior still sheds light on who and what we are today!


23 comments:

  1. "It ceased to be a very good rule when it became fairly obvious that the president of the United States might be suffering from a major psychiatric disorder. "

    If the president (or a candidate) has no psychiatric disorder, then you wouldn't need such a rule at all. It is when a person likely has such a disorder that the rule becomes most important.

    Patient (client) confidentiality is a keystone upon which practice depends because without the assurance of confidentiality, people who need help would perceive too great a danger in confiding in a therapist or doctor. Thus they would not receive necessary treatment. Others witnessing the disclosure of confidential information might similarly avoid seeking help and the profession would become ineffective at treating the population who most needs its services -- those with disorders.

    Somerby might argue that the public needs to be protected from a disordered candidate or president, but there is no evidence that a mental disorder, properly treated, is necessarily disabling or that it would preclude public service. It is the opposite -- the failure to ensure confidentiality, which would drive someone away from treatment, is more likely to be damaging to the public should such a person seek office.

    Somerby doesn't understand what he is talking about. That's another reason why professionals should not introduce comments about mental health of candidates into public discourse. Idiots like Somerby would say stupid things that would be damaging to both the public and the person being maligned by a psychiatric label.

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  2. Jeez. Calm down already, dear Bob.

    To begin with, politicians, all of them, aren't normal people. If they aren't, they have to act like psychos, or they will never succeed, never get elected. The one without moral qualms always have an advantage.

    Also, those who show off their 'empathy' every time they open their mouth, bite their lip, and repat "I feel your pain", are way more likely to be real psychos. That's just common sense; obvious to anyone who's not suffering from TDS like yourself.

    And finally, what do you think about this little video, dear Bob: "we came we saw he died"?

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    1. Great. So Clinton is a psycho that kills the citizens of and destroys other countries and Trump is a psycho that kills the citizens of and destroys the country he is supposed to protect.

      I'll take Clinton.

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  3. "Instead, our press corps focuses on whatever Donald J. Trump said or tweeted ten minutes ago."

    Here, Somerby confuses the profession of journalism with the profession of psychiatry. It is not the job of journalists to speculate about whether a president has a psychiatric disorder, and if so, which one. They do not have the training to do so.

    The DSM lists diagnostic criteria in the form of checklists and that encourages idiots like Somerby to think that they can just apply the list and see whether someone qualifies for a diagnosis or not. It is tempting to apply this to one's mother-in-law or boss or prospective girlfriend. But the expertise lies in recognizing from behavior (what someone says and does) what may be going on in someone's mind. All behavior occurs in a context that must be understood in order to know what behavior means. Testing is needed in order to recognize subtleties and eliminate bias (subjectivity of interpretation) and to compare a person's behavior with norms. Somerby thinks he can read a list of criteria (without understanding the jargon in those lists) and just apply them himself without any experience with what a truly abnormal person is like compared to someone who is functioning well but a bit eccentric. Somerby is an asshole to think this.

    The consequences at stake if people start doing this to each other are staggering to think about. People could be fired from jobs or damaged in their communities by ignorant application of poorly understood criteria. Doctors will be flooded by concerned individuals dragging their children or spouses in to have them treated when there is nothing wrong with them. The new Salem Witch Trials would begin as people accuse those they dislike of having psychiatric symptoms. This happened to a small extent back when psychoanalysis was popular and people were accused of neuroses, but only a minority took Freudian analysis seriously, so mainly only authors and celebrities were harmed (but recall Fawn Brodie's psychoanalytic interpretation of Nixon's life). Professional dictates are intended to protect people from this kind of misuse and abuse of tools intended to help people, not label and persecute them.

    If Trump is truly diagnosable, the last thing we need is for the Democratic Party and liberals to be accused of persecuting the president using psychiatric terminology, calling him unfit for office not because of his actions but based on expertise that will seem arcane to the average person and to be treason on the part of an educated subgroup in a politically motivated vendetta against a duly elected officeholder.

    This is what Somerby is advocating. It would ruin liberals and Democrats and do nothing to shake the faith of Trump's supporters, who identify with him and therefore will defend him from assaults on his sanity, perceived to be similar to their own.

    Somerby is crazy to propose this. Or he has malevolent intent toward liberals and Democrats. I suspect the latter, since that is consistent with his ongoing defense of Trump and repetition of conservative memes and talking points here. Don't be tempted. It may feel good to have a name for what is wrong with Trump, but that isn't the purpose of psychiatry. There are better names with fewer consequences, politically speaking. Such as incompetent, immoral, and corrupt. Why are these names not good enough to motivate removal of Trump? They should be all we need to know to remove the man during the next election, now less than a month away.

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    1. You do not understand the dynamic at play here. Somerby needs to bolster his reputation after his AMT fiasco, so he trots out his Trump-has-a-mental-disorder and spices it up with some red meat for us liberals (usually it is applied as some sort of defense for Trump), all in an effort to mesmerize us away from his embarrassing mistake.

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  4. "Imagine if a major journalist ever said something like this:

    "Well, we're not doctors or medical experts. All we can do is describe the 200,000 deaths.""

    This is what we already do. There is a great deal of confusion about whether to classify someone who dies of respiratory failure (or kidney or heart failure) as a covid death or the result of some underlying condition that made that person vulnerable to covid.

    Different jurisdictions have adopted different definitions of covid death. Some require a positive covid test (but even these have false positive and false negative rates). Some journalists have looked at excess deaths, comparing this year's stats with those for other time periods to see how many additional deaths have occurred that might be related to either lack of medical resources or undiagnosed covid.

    It does take some medical and public health expertise to figure out how many people have actually died. Instead we have adopted a consistent definition and noted the increases and decreases, not pretended that this is an accurate count of how many people have actually died from covid.

    Journalists are not experts and they do simply report what other people, presumably more expert, have told them. It is what they do.

    This is the same complaint Somerby raises when he insists that reporters must be trained education specialists in order to write about education issues. It is a misunderstanding of what journalists do and how someone is educated to become a journalist. Many of his criticisms of people who work in journalism are based on this misconception and it is both unfair and unrealistic to expect otherwise. If someone is an education specialist, for example, they can work in any number of better paying and more interesting jobs in education, they may not have the writing skills, and they may not have the interest in doing journalism instead of the work that they are trained to do in education.

    Somerby claims to think critically about things, but he shows an extreme lack of common sense in the demands he repeats here incessantly when it comes to the press.

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  5. "When Donald J. Trump got into that car with those Secret Service agents, an obvious possibility became obvious once again."

    Why did anyone let Trump do that? Talk about enablers! Why does Trump's staff and his doctors not talk him out of these ill-advised stunts?

    Holding Trump alone responsible for this kind of thing lets the rest of his staff off the hook. There was no national interest served by this, and I believe his secret service agents should have refused to participate. Would Trump have gone out without their protection?

    Why does no one tell him no? That is the question that Somerby should be asking, not why does Trump do such things. He is campaigning and trying to appear less sick while down with covid. Those are rational actions. If they are wrong, it is up to the people who surround him to explain that to him and to exert pressure to stop him from behaving foolishly.

    I have been wondering when and why those around Trump abdicated their own responsibilities, public and private. Somerby clearly has no interest in holding anyone accountable for actions, not even Trump himself, who he wishes to excuse and pity. If Trump is mentally ill, what is the excuse of his staff?

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  6. "The founder of the Proud Boys joined the vigil for Donald Trump outside Walter Reed Medical Centre this weekend after the president gave a shout-out to the far-right group during the first presidential debate.

    He was spotted in the crowd, draped in what appeared to be a Trump/Pence campaign flag, outside the Maryland hospital by a CNN video producer. Mr McInnes also appeared to be holding a Budweiser beer and not wearing a mask."

    If Trump has a psychiatric disorder, what explains his supporters' behavior?

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  7. Trump's syphilitic-ridden brain functions like a two-year olds. Even after he was told Hope Hicks had the virus, he still couldn't stop himself from grabbing her by the pu**y.

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    1. In Trump's defense, "grabbing her by the pu**y" is not how the virus is transmitted.

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    2. Not true, if he's not wearing a mask.

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  8. A doctor over the weekend said that if they had a patient who did what Trump did in going riding in his limousine, she would have him isolated and order a psychiatric evaluation.

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  9. “Instead, our press corps focuses on whatever Donald J. Trump said or tweeted ten minutes ago.”

    And how does focusing on Trump’s sociopathy accomplish anything different?

    Besides, to show that Trump is a psychopath, you have to focus on whatever Trump tweeted or said, since that’s really all we have to go on.

    It’s more important to highlight what his enablers are doing, such as rigging the election in order to make Trump’s tweets, where he rants about a rigged election, come true.

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  11. After years of demanding journos not play armchair psychiatrists, Bob started Berating journos for NOT doing just that. Today he is sort of all over the map, anything but holding Republicans responsible for the insanity they have created.

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  12. If Trump suffers from a serious psychiatric disorder - he's a sociopath = as TDH keeps harping on, then surely Stalin, Hitler, Pol Pot, Mao, Ivan the terrible, etc. etc. surely also suffered from the same unfortunate condition, perhaps to a more serious degree. And by TDH's logic, we shouldn't loath any of them - our attitude be one of pity and concern.

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