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!