May 24, 2011

Should psychiatrists offer opinions about the mental conditions of various characters in the news?

The official rule of the American Psychiatric Association is that they can speak generally but it's unethical to give a professional opinion about an individual. The rule grew out of a case involving Barry Goldwater:
Just before the 1964 election, a muckraking magazine called Fact decided to survey members of the American Psychiatric Association for their professional assessment of Senator Barry Goldwater of Arizona, the Republican nominee against President Lyndon B. Johnson....

The survey, highly unscientific even by the standards of the time, was sent to 12,356 psychiatrists, of whom 2,417 responded. ... Half of the respondents judged Mr. Goldwater psychologically unfit to be president. They used terms like “megalomaniac,” “paranoid” and “grossly psychotic,” and some even offered specific diagnoses, including schizophrenia and narcissistic personality disorder....

There were several attempts at a psychodynamic formulation of Mr. Goldwater’s character. One unsigned comment called the candidate “inwardly a frightened person who sees himself as weak and threatened by strong virile power around him,” and added that “his call for aggressiveness and the need for individual strength and prerogatives is an attempt to defend himself against and to deny his feelings of weakness.”...
Goldwater sued for libel and won, which led to the APA rule barring opinions. Obviously, it brings psychiatry into disrepute when ordinary people can see it used dishonestly to promote a political goal. But I don't see why it's so bad for psychiatric experts to speculate and opine about public figures. We the people need to think about the events in the news, and some expert opinion is helpful. Let us decide which experts are worth hearing from. The political hacks will be enjoyed or condemned as we see fit. But some analysis is going to be good. Frame it as speculation and hedge appropriately: I would need to meet with the individual to make a professional diagnosis, but here's what I can say....

If the experts don't do it, the pseudoexperts will. As for the fear of lawsuits, libel law is constrained by free speech values. Mere opinion in not libel. And public figures have to meet a high standard to prove libel.

Why then did Goldwater win his lawsuit? The linked article, by psychiatry professor Richard A. Friedman and published in the Science section of today's New York Times, says:
The Supreme Court awarded the senator $1 in compensatory damages and $75,000 in punitive damages — and, more important, set a legal precedent that helped change medical ethics for good.
Of course, any lawyer knows that the Supreme Court doesn't award damages. It only affirms the lower court's decision. But what is this Supreme Court case and how did it deal with the free speech issue? Hello? New York Times? Don't you wonder how this case would square with New York Times v. Sullivan (second link, above)? So did Justices Black and Douglas, dissenting from the denial of certiorari in Ginzburg v. Goldwater! Justice Black wrote:
This case perhaps more than any I have seen in this area convinces me that the New York Times constitutional rule is wholly inadequate to assure the 'uninhibited, robust, and wide-open' public debate which the majority in that case thought it was guaranteeing....
This suit was brought by a man who was then the nominee of his party for the Presidency of the United States. In our times, the person who holds that high office has an almost unbounded power for good or evil. The public has an unqualified right to have the character and fitness of anyone who aspires to the Presidency held up for the closest scrutiny. Extravagant, reckless statements and even claims which may not be true seem to me an inevitable and perhaps essential part of the process by which the voting public informs itself of the qualities of a man who would be President. The decisions of the District Court and the Court of Appeals in this case can only have the effect of dampening political debate by making fearful and timid those who should under our Constitution feel totally free openly to criticize Presidential candidates. Doubtless, the jury was justified in this case in finding that the Fact articles on Senator Goldwater were prepared with a reckless disregard of the truth, as many campaign articles unquestionably are. But, even if I believed in a balancing process to determine scope of the First Amendment, which I do not, the grave dangers of prohibiting or penalizing the publication of even the most inaccurate and misleading information seem to me to more than outweigh any gain, personal or social, that might result from permitting libel awards such as the one before the Court today. I firmly believe it is precisely because of these considerations that the First Amendment bars in absolute, unequivocal terms any abridgment by the Government of freedom of speech and press.
So the jury found that the New York Times standard was met, and the Court of Appeals affirmed. The Supreme Court declined the case, with Justices Black and Douglas arguing for greater free-speech protection.

And when I say "the New York Times standard was met," I mean the legal standard from the case New York Times v. Sullivan. I do not think the New York Times standard of journalism was met for this article!

56 comments:

Triangle Man said...

I think psychiatrists should limit their assesment to a broad scale:

1) Eccentric
2) A little bit off
3) Loony
4) Crazy
5) Totally fucking nuts

Triangle Man said...

How about all candidates undergo a thorough psychiatric evaluation with a panel of examiners and the complete results are published online?

Jim said...

It is far different thing for an amateur to offer such an opinion, than it is for a licensed professional.

The difference is obviously the weight which is given to the opinion.

The sole purpose of the Fact article was to create a scientific certainty around what was clearly nothing more than a purely political statement.

It is no wonder that Leftists would want to able to manipulate the public debate by being able to give the air of scientific certitude to decidedly political statements. After all, they've spent decades systematically excluding and demonizing conservative opinions from higher education. So which side of the political debate would have a decided advantage were such a standard to be allowed?

Free speech is free speech. But the whole idea of libel and defamation laws is to instill at least the most minimal level of personal responsibility into that free speech. What you're advocating is essentially making those laws meaningless.

Why couldn't engineers simply look at a building and declare it unsafe and destroy the business of the landlord? After all, free speech is free speech, right?

Jim said...

How about all candidates undergo a thorough psychiatric evaluation with a panel of examiners and the complete results are published online?

Given the extreme Leftist bent of the psychiatry/psychology field in general, that would lead to predictable results EVERY SINGLE TIME.

So how about NO?

shoutingthomas said...

As long as you remember that the APA is relentlessly PC, long gone on loony feminism and hates men...

You are welcome to consider their opinions.

Fuck them.

Ricardo said...

I used to love the pieces that Gail Sheehy wrote for Vanity Fair, getting into the motivation why public figures ran for political office, and what was actually going on in their heads. Her book "Character: America's Search for Leadership" is still a classic (IMO). I don't think it requires psych credentials to write informative and accurate pieces on politicians, just a lot of intuition, clear thinking, and honesty.

CatherineM said...

Do you read Dr. Helen? The psych magazines are very political and pointless.

I am too cynical to believe there would be accurate assessments. They do "studies" often that always claim conservatives are whacko racist meanies and liberals are angelic good people serving a higher purpose.

The psych exams would mean nothing.

Jim said...

As long as you remember that the APA is relentlessly PC, long gone on loony feminism and hates men...

This is the same group that actually forces their membership to talk to clients about their environmentalism.

Patient: Doc, I've been seriously considering slitting my wrists...

Doc: We'll get to that in a minute. We have to take care of the important stuff first. DO YOU RECYCLE?

The APA is a joke. A bad one. They are one of the main reasons that the field gets a bad name.

E.M. Davis said...

Wait, wasn't LBJ the one picking puppies up by their ears?

Henry said...

Following up on E.M Davis:

LBJ also liked to berate people while sitting on the shitter.

All good healthy fun.

w/v: healify. Psych's, healify yourselves.

t-man said...

Outside of a criminal trial and custody battles, is it really part of the profession of psychiatry to offer opinions the mental health of third parties? Does psychiatry accept the practice of diagnosing people who have never been examined in a clinical setting?

If you are are looking for "expert opinion", shouldn't the "expert" at least be following the accepted practices of the profession?

"Let us decide which experts are worth hearing from" is a long-term game, which doesn't help in drive-by campaign hits. There are plenty of medical professionals who are willing to drop their ethics for political reasons (see "Wisconsin Protest Doctor's Notes.")

Fred4Pres said...

Their opinions are not worth more than the average blogger. I would guess less than that.

Does that mean lawyers cannot comment on law blogs? Doctors on medical blogs?

Pogo said...

Psychiatry has a horrible history of abuse of the profession for political purposes, especially by leftist regimes (USSR).

Flippant and nonclinical "diagnoses" diminish the trust needed for their work.

They cannot tell me whether a candidate is evil, and they have a poor track record in picking out the sociopaths.

JFB said...

And thank you, Althouse, for providing a rationale for the continued pollution of America by the like of Nancy Grace and her cohort of opinionated idiots.

WV: ouckism. I'll say.

7584e744-861c-11e0-b43d-000bcdcb8a73 said...

Remember how President Gerald Ford, during his confirmation hearings to be vice president, felt obliged to address suggestions that he'd undergone psychiatric treatment? He told a Senate panel that he'd never undergone such treatment, and said that he was "disgustingly sane."

WV: deblem.

a psychiatrist who learned from veterans said...

Behavior in the marketplace is kind of technology driven. Given computers and the internet then something like e-bay or craigslist is possible. In psychiatry, the French tried a new antihistamine to sedate schizophrenic hospitalized patients in 1953 and the patients improved; SKF later gave free phenothiazines to one ward of a Texas state hospital and invited the legislators to the hospital later. The results were impressive. The furniture bill due to broken up furniture was reduced on the medicated ward. The legislators authorized purchase of the medication. We hadn't gone too far from that in terms of meds. One diagnostic scheme for schizophrenia involved Bleuler 4 A's: autism, association, affect, and ambivalence. It might be helpful to give some one a neuroleptic (phenothiazine) who say was distraught over a romantic breakup on the theory that they weren't self contained enough, their self as it were bled over from someone else. It's not that they were hearing voices, what might be looked at as a boundary issue, but still there were boundary issues. It might be seen as autism, the whole word is me version. I assume the readers of this liberal magazine thought well, that Goldwater is a little autistic from
my point of view; maybe so but they also showed they were a little autistic too.

Carol said...

Fact magazine, LOL. As a precocious 12 YO I read a copy I found on my uncle's coffee table, and for dinner conversation asked, did you know Dag Hammersjold is a homosexual?? I don't think I even knew what that meant. Who was behind that rag anyway?

Anyway, I hate shrinks the way others hate lawyers. Especially if their "analysis" is based on someone's errant opinions. When I was growing up shrinks were like priests to my family, always on the lookout for sin (neurosis), always there to tell you that something about you just ain't right.

They can't make any judgments that we can't make ourselves just by listening and watching.

Ann Althouse said...

"Fact magazine, LOL. As a precocious 12 YO I read a copy I found on my uncle's coffee table, and for dinner conversation asked, did you know Dag Hammersjold is a homosexual?? I don't think I even knew what that meant. Who was behind that rag anyway?"

Ralph Ginzburg! His more famous magazine was Eros, and he went to prison for it:

"Eros, which was sold only through the mail, was conceived in a hardcover rather than a softcover format as a marketing ploy to extract a hefty cover price. Mr. Ginzburg hired the leading mainstream advertising typographer/art director, Herb Lubalin, to create innovative layouts for Eros. It cost him a lot of money to produce and never rose out of the red. When the fourth and final issue appeared (a fifth was prepared but never published), Mr. Ginzburg was indicted on charges of violating a federal statute that regulated obscene advertising. His publications (Eros; Liaison, a biweekly newsletter; and "The Housewife's Handbook on Selective Promiscuity") were deemed obscene "in the context of their production, sale and attendant publicity." After various appeals, the case was argued before the Supreme Court in 1965, and in 1966 Mr. Ginzburg's conviction was upheld. Despite protests by First Amendment advocates, he served eight months in a federal prison in 1972 after the Supreme Court refused to hear an appeal of his sentence."

Ann Althouse said...

By the way, I knew one of his daughters slightly and was once in his apartment, possibly during the period when he was in prison. I have a vague memory of what the apt -- in Manhattan -- looked like. Hip. Full of books. This was back in the 60s. It was hard for me to understand how he could be in prison, but I didn't have any clear idea of what "obscenity" was.

I say that as a person who grew up in a household where Playboy magazine was always left out on the coffee table for anyone to peruse unmolested.

We got Fact magazine too. I remember being freaked out by an article on circumcision. I still remember the title of the article; "The Unkindest Cut."

J said...

Mencken penned some thoughts along these lines--- [W]hen a candidate for public office faces the voters he does not face men of sense; he faces a mob of men whose chief distinguishing mark is the fact that they are quite incapable of weighing ideas, or even of comprehending any save the most
elemental—men whose whole thinking is done in terms of emotion, and
whose dominant emotion is dread of what they cannot understand. So
confronted, the candidate must either bark with the pack or be lost….......On some great and glorious day the plain folks of the land will reach their heart’s desire at last, and the White House will be adorned by a downright moron.
.....



President Alfred E Newman! aka Bush II.

Henry said...

@J -- You've spotted a trend.

J said...

Not exactly, Miss Henry--though Mencken's point regarding the dangers of mob democracy are a bit too subtle for you, or most Gumphousers--stick to the Harry Potter shows.

Scott M said...

Why does "mob democracy" require both words? Democracy is "mob" by definition.

J said...

There could be a smart democracy , possibly--wasn't that what those Founding gumps Jefferson, Madison, etc hoped for? --tho Mad. slightly closer to republican views (in classical sense, not Reaganite). Not that it turned out as such-- then, the know-nothing GOP yokels probably outnumber the illiterate populist Demos (tho may be pretty close in areas)...so in effect, the right depends on appealing to the ...GOP voter's stupidity.Sort of explains the Palin phenomenon.

Joanna said...

various characters in the news

What about Charlie Sheen? Weren't people in the field offering opinions that he's a junkie and/or bipolar? For that, it was almost the opposite of political psychiatry; it felt like people were looking for a reason to explain or even excuse his behavior. Nobody wanted to accept that he might just be an asshole. (Or were "professional" opinions being sought just so the news could milk his situation and boost their ratings?)

Is there much difference between offering psychiatric opinions about living people based on all available evidence (except one-on-one conversation) and doing the same for dead people? (example: Lincoln --> Depression; Virginia Woolf --> Bipolar; Jefferson --> Aspergers.)

DADvocate said...

I don't see why it's so bad for psychiatric experts to speculate and opine about public figures.

Read some of Thomas Szazs' work and you'll understand why it's bad for psychiatirc experts to speculate and opine about nearly anyone. Their "knowledge" is highly open to interpretation, they have a strong bias towards believing everything is pathological and little sound scientific basis for much of their belief.

ricpic said...

With the exception of Trey they're all untrustworthy metrosexuals. ;^)

Hagar said...

Testing

traditionalguy said...

Before a person is elected President, he/she should first have to live with the country long enough for all of their hang ups and mean selfish tendencies to be seen. That is why we hesitate to elect the untested newbie spinning a folksy myth about himself. Ergo, Pawlenty has a long way to go and a short time to get there. Sarah Palin and Mitt Romney are over that test period hump. In Obama's case we got drug kicking and screaming back into mythical world of the noble black man doing a Jackie Robinson to free his race. Our lesson is to learn that an untested mythical person can also be a dangerous man dedicated to defeating us.

Oligonicella said...

"I do not think the New York Times standard of journalism was met for this article!"

*Any* article can meet NYT standards as there are virtually none concerning accuracy.

To the point: a psychiatrist who publicly 'analyzes' someone should be run out of business.

DADvocate said...

With the exception of Trey they're all untrustworthy metrosexuals. ;^)

Trey is an exception, and he's a psychologist, not a psychiatrist. Most legal occupations have at least a few good eggs.

Oligonicella said...

Ann Althouse --

"... but I didn't have any clear idea of what "obscenity" was."

*Nobody* has a clear idea of what obscenity is. We only know what we personally don't like.

Hagar said...

Justice Black was not all that respectful of the 4th and 5th Amendments when he was FDR's enforcer in the Senate and not notably enthusiastic about the 13th, 14th, and 15th in his Alabama days.

As for the Professor's question, I would get in trouble if I were to publish unsupported comments about the bridge collapse in Minneapolis with injudicious comments about the engineering design of the bridge, while she, as a law professor, but a lay person as far as engineering is concerned, would be fairly free to speculate.

Similarly a person holding a license to practice psychiatry (MD + psychology) has an obligation to practice his profession in a responsible manner and may be sued if he does not.
The term "professional" applies to vocations that require special knowledge and skills not readily adjudged by a lay person, and where the results of malpractice may be grievous to society. Such persons are given special privileges by society, but with that comes also special obligations.

B said...

'J said...
"[W]hen a candidate for public office faces the voters he does not face men of sense; he faces a mob of men whose chief distinguishing mark is the fact that they are quite incapable of weighing ideas, or even of comprehending any save the most
elemental—men whose whole thinking is done in terms of emotion, and
whose dominant emotion is dread of what they cannot understand. So
confronted, the candidate must either bark with the pack or be lost…"

Nonsense. Mencken's disdain for the capabilities of the voters as a group says a lot about Mencken and a lot more about any elitist jacka$$ who buys into his tripe than it does the voter.

Having said that, there are a lot of voters who are 'quite incapable of weighing ideas, or even of comprehending any save the most
elemental'. Witness the last presidential election and all the chuckleheads who bought into the empty rhetoric of Obama's Hope and Change mantras and tipped the White House to Obama. But they, and I include you in that group J, are not the majority of voters.

Hagar said...

My computer have been making "knepping" noises all day when clicking in the Althouse blog and has not allowed me to comment due to "interior conflicts," or something.
(Perhaps a psychiatrist was needed at Google?)

Anyone else experience this?

J said...

3:56. Bubba B, Mencken's obviously a bit too steep for you. Maybe stick to the Larry the Cable Guy videos? Yeah.

Mencken while not down with socialists did oppose the Klan and biblethumpers--which is to say he would not likely have approved of the tea party or Foxbot sorts, or you, B.

Penny said...

B said "Nonsense. Mencken's disdain for the capabilities of the voters as a group says a lot about Mencken and a lot more about any elitist jacka$$ who buys into his tripe than it does the voter."

Let's hope so, B. However I did find myself concerned about this poll.

"They're not buying it. Most Americans say they don't believe Medicare has to be cut to balance the federal budget, and ditto for Social Security, a new poll shows."

I doubt Mencken would be surprised by this. How about you, B?

kcom said...

"The public has an unqualified right to have the character and fitness of anyone who aspires to the Presidency held up for the closest scrutiny."

A right we were denied at the last election by the most sycophantic press in U.S. history. Rather than a close inspection, we had only a cursory one. We still have less documentation on Obama than any previous president. Do you think any other presidential candidate would have gotten the pass on Tony Rezko that Obama got?

Richard Fagin said...

"The New York Times v. Sullivan" opened the door to libel and the decline of journalism. Even the standard cied in the holding "actual malice" is confusing enough to the orindary juror. Gen. Westmreleand should have won his case against CBS. If a phsyciatric profressional has not presonally examined the subject, his public statements should be the basis for a libel claim.

PaulV said...

Until the good chemicals were developed spontaneous recovery from insanity for people housed in insane asylum exceeded best results of the trained professionals. Yes, it is unprofessional to offer an opinion for someone you have never met. Just as offering an opinion on a bridge that fell down without examing the rubble. LBJ was the loon, for sure.

HT said...

Jim said...



Given the extreme Leftist bent of the psychiatry/psychology field in general, that would lead to predictable results EVERY SINGLE TIME.

So how about NO?

5/24/11 9:28 AM

0000000

Peter Breggin's not a leftist. He's a rightist.

Francisco D said...

I can assure you, as a psychologist for 25 years, that psychiatrists are less capable than most MDs of giving a proper psychiatric diagnosis.

Their job is to dispense medication and see people for 5 minute med checks. The field has been a joke in the medical community for decades.

HT said...

You said it brother!

Hagar said...

It is more than just "unprofessional."
Society relies on the words of professionals and so attaches special value to them, and will hold professionals responsible for what they say, since they are not just citizens exercising their right to "free speech."

virgil xenophon said...

HAGAR/

It happened to me also--I just got in after restarting my computer after shutting it down for a few hours when doing other things. M'things after the first couple/three trys/"rejections" for whatever reason, Blogger won't allow admission for security reasons until some unk time period has passed and you approach it with "fresh cookies" (as it were)from a restart.

Paul Zrimsek said...

If psychiatrists are such quacks then who cured all those homosexuals, huh? One day they all had a disease, the next they were all better. Like to see some of you jamokies pull off a miracle on that scale.

virgil xenophon said...

Richard Fagin@5:25pm/

You're so right. It didn't help that Sullivan was a thoroughly despised person and goes to show that the SCOTUS not only follows the election returns; it has an often exquisite ability to sniff out the zeitgeist of the times--and Sullivan was very DEFINITELY not a figure congruent with--did not fit into, was not muy simpatico--with those times.

Paul Brinkley said...

The trouble I see with such published analyses is that they provide the public with little perspective. It'd basically be more proofs of argument unless we first slathered the public in a very healthy shroud of training in critical thinking. Even smart people can be misled some of the time.

In other news, a few people would wonder why the practice only gets brought up when the incumbent is a Democrat.

If you want the analysis to be somewhat scientific, best to make it at least partially blind.

Start by compiling the stock questions psychiatrists say they will need the answers to.

Then compile the answers to those questions for all of the candidates, along with at least an equal number of non-candidates. None of the questions can be allowed if they would allow the psychiatrist to positively identify any of the people.

Randomize the personalities, and let the psychiatrists go to work.

Once the results are gathered, then reveal the identities.

By the way, some of the non-candidates will include a few of the psychiatrists themselves.

THAT, I would be comfortable with publishing.

Paul Brinkley said...

s/proofs of argument/arguments from authority

William said...

Over the years this issue has done far more to discredit psychiatry than it has to discredit Goldwater.

William said...

@HAGAR AND OTHERS WHO HAVE TROUBLE GETTING THEIR COMMENTS ACCEPTED: Log on to Althouse using the althou.se url.

TMink said...

Ricpic, if it weren't metro, I'd kiss you.

Trey

JAL said...

No.

At least not the kinds that were used as illustration's in the article. Of course it was 1964 ...

No one in his right mind would toss out "schizophrenic" as a diagnosis of Goldwater based on his behavior. Yikes!

And if saying these things as professionals was going to influence the election and deprive people of information they needed to make an informed decision .... When does that become a RICO issue? And when is it the down and dirty of politics?

The fact that they were professionals pontificating (and pretty extremely, I think,) makes a difference.

A "displays some narcissistic traits" comment is more defensible. Of course, I've heard that under the new DSM narcissism is no longer a diagnosis. (Was hitting too close to home, me thinks.)

JAL said...

Of course, seeing the metrosexual comment one must add that if psychiatry is going the way of the other mental halth professions (and medical school enrollments also) women are going to be running that show too, and heavens to betsy! Forget Barry Goldwater -- Men are really going to be an endangered species.

wv losts
How many losts were there?

B said...

J said...
"Bubba B, Mencken's obviously a bit too steep for you."

Nope. The guy is not that deep, but he is way above you by so many levels it's pathetic. My other comment was just noting that the quote you pulled up appeals to a$$hats with little to no grasp of what actually happens in the American political process.

" Maybe stick to the Larry the Cable Guy videos? Yeah."

Sorry. Don't do TV. Do get a kick out of your typical liberal arts education intellectual arrogance though. Especially displayed here where most of the commenters consider you a light weight at best. Surprised that you didn't use your latest 'bait shop owner' comedy routine.

"Mencken while not down with socialists did oppose the Klan and biblethumpers--which is to say he would not likely have approved of the tea party or Foxbot sorts, or you, B."

Actually, that is projection. What Mencken was down on was people who operated on emotional triggers without considering cause and effect. He would have admired the Tea Party for rejecting emotional triggers and appeals to 'hope and change' bible thumping analogues in favor of accepting that instant gratification has future consequences. Mencken liked people who use their heads. Mencken would have disdained the the current crop of democrats, not liberals but the progressive left that has hijacked the party, as exactly what he despised about socialists and tossed them into the same bucket as the Klan.

He would have had no time at all for a risible chucklehead like yourself.

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