Charles Krauthammer: Hack psychiatrist

It infuriates me when pundits pretend to diagnose mental illness in their political opponents, but at least it's obvious in most cases that the speaker has no psychiatric expertise. That's not true, however, with the Washington Post's Charles Krauthammer, an actual psychiatrist.

Via P. O'Neill, the latest example comes from a Krauthammer column earlier this month bashing President Obama's treatment of US allies (emphasis added, italics in original):

Well, said David Manning, a former British ambassador to the United States, to a House of Commons committee reporting on that very relationship: "[Obama] is an American who grew up in Hawaii, whose foreign experience was of Indonesia and who had a Kenyan father. The sentimental reflexes, if you like, are not there."

I'm not personally inclined to neuropsychiatric diagnoses, but Manning's guess is as good as anyone's. How can you explain a policy toward Britain that makes no strategic or moral sense? And even if you can, how do you explain the gratuitous slaps to the Czechs, Poles, Indians and others? Perhaps when an Obama Doctrine is finally worked out, we shall learn whether it was pique, principle or mere carelessness.

Despite his claim to not be "personally inclined to neuropsychiatric diagnoses," Krauthammer has repeatedly speculated about his opponents' mental condition and joked about their need for psychiatric medications:

-"I'm a psychiatrist. I don't usually practice on camera. But this is the edge of looniness, this idea that there's a vast conspiracy, it sits in a building, it emanates, it has these tentacles, is really at the edge. [Al Gore] could use a little help." (Fox News Sunday, 12/1/02)

-"The media could use some lithium. Not since I studied bipolar disease 25 years ago have I seen such dramatic mood swings as in the coverage of the first week of the war." (Washington Post, 3/28/03)

-"Now, I cannot testify to Howard Dean's sanity before this campaign, but five terms as governor by a man with no visible tics and no history of involuntary confinement is pretty good evidence of a normal mental status. When he avers, however, that 'the most interesting' theory as to why the president is 'suppressing' the Sept. 11 report is that Bush knew about Sept. 11 in advance, it's time to check on thorazine supplies." (Washington Post, 12/5/03)

-"Well, it looks as if Al Gore has gone off his lithium again." (Fox Special Report, 5/25/04)

-"In the face of Gore's real breach of civil political discourse, which of the following is the right corrective: (a) offer a reasoned refutation of the charge that George Bush is both Stalinist and Hitlerian; (b) suggest an increase in Gore's medication; or (c) do a Cheney." (Washington Post, 7/2/04)

-Gordon Peterson: "Charles, you're a psychiatrist: is he [former FEMA head Michael Brown] delusional?"

Krauthammer: "Well, he could use some medication." (Inside Washington, 10/2/05)

-"As we can see, some of the proponents [of immigration reform] here need an adjustment of their medication." (Fox Special Report, 5/11/06)

-"There's no way you're going to -- this is a guy [South Carolina governor Mark Sanford] who, it looks to me as a long-distance diagnosis, a guy who is committing a near intentional -- political suicide." (Inside Washington, 6/28/09)

-Mark Shields: "Charles Krauthammer, last week on this show -- no -- you said that we were watching a man [Mark Sanford] go through a public nervous breakdown...

Krauthammer: "Listen, it wasn't a hard diagnosis. (Laughter.) You don't need a license, even though I still have one." (Inside Washington, 7/5/09)

Krauthammer also defended former Senate Majority Leader Bill Frist's long-distance diagnosis of Terri Schaivo on the March 27, 2005 edition of Inside Washington:

MS. TOTENBERG: The cravenness - excuse me - I just think the cravenness of Bill Frist going to the floor of the Senate and saying, I have reviewed what turned out to be edited, surreptitiously recorded videotapes of this woman and I have made a diagnosis that you should all now follow. I mean, does anybody really think he would have done that when he was a doctor doctor?

MR. KRAUTHAMMER: You just commented on surreptitiously recorded tape of Tom DeLay without any hesitation. Why shouldn't a doctor use - surreptitiously used video -

MS. TOTENBERG: Because he didn't examine her.

MR. KING: But the issue is -

MR. KRAUTHAMMER: Because you go on the evidence that you have. The husband has not allowed a lot of testing in the last three years.

MR. KING: Bill Frist -

MR. KRAUTHAMMER: And we don't know a damn thing. We ought to have a functional MRI and a PET scan and that hasn't been done and in the absence of that you have no way of knowing...

What's so bizarre is that at other times Krauthammer has condemned ad hoc psychologizing. For instance, in 2007, he correctly denounced a speculative column attempting to diagnose Dick Cheney with dementia. And back in 1999, he described such long-distance diagnoses as psychiatric malpractice:

As a former psychiatrist, I know how difficult it is to try to understand the soul of even someone you have spent hundreds of hours alone with in therapy. To think that one can decipher the inner life of some distant public figure is folly.

Even the experts haven't a clue. Remember that group of psychiatrists, 1,189 strong, who in 1964 signed a statement asserting their professional judgment that Barry Goldwater was psychologically unfit to be president? The very attempt to make such a diagnosis at a distance is malpractice.

Indeed. Does the American Psychiatric Association have a professional misconduct policy?

Comments

[David]

Hanlan's Razor: Never attribute to malice that which can be adequately explained by stupidity.

Occam's Razor: "entities must not be multiplied beyond necessity" and the conclusion thereof, that the simplest solution is usually the correct one.

These two principles indite Krauthammer's foolish support of some theory involving Obama's "sentimental reflexes"*. It's more likely that being inexperienced in foreign diplomacy, Obama simply behaved stupidly.

*I would like to ask Dr. K just where these "sentimental reflexes" are situated. Have they been identified somewhere in the cerebellum?

[Fred A Milton]

Brendan's attack is bogus. Krauthammer's comment merely indicates his tentative sympathy with a Brit's speculation that Obama, because of his upbringing, may lack "sentimental reflexes" of attachment to Great Britain.

Krauthammer's point is innocuous, and does not rise anywhere near the clinical psychoanalytical pronouncement that Brendan is attempting to hype it into.

[Fred A Milton]

To compare Krauthammer's speculation about Obama's sentiments toward England to someone's "attempting to diagnose Dick Cheney with dementia" is ridiculous.

Fail.

[Fred A Milton]

Hello Brendan,

How would you judge the mental state of an intelligent, well-informed man who asserted that "'the most interesting' theory as to why the president is 'suppressing' the Sept. 11 report is that Bush knew about Sept. 11 in advance" ?

If you speculated about the mental state of the man making the assertion, would you be engaging in "hack psychiatry"? How crazy does the assertion need to be before you allow such speculation?

On the other end of the spectrum, is any mental state speculation, no matter how bland and general, permitted without your labeling the speculator a hack psychiatrist?

If you call Krauthammer out for concurring with someone's speculation about Obama's sentiments toward England, will you condemn the doctor if he observed that, in some future instance, Obama seemed, say, happy?

[Howard.Craft]

Krauthammer's grasp of foreign policy issues and his examples (that somehow illustrate "carelessness") seem pretty superficial. His column is like the old sit-com Seinfeld; its "about nothing".

[Dr X]

Krauthammer's medical license is active (in D.C).

Principles of Medical Ethics, with annotations applicable to psychiatry:

Section 7: Item 3 addresses your question. It is not ethical to render a psychiatric opinion regarding a specific individual who has not been personally examined by the psychiatrist.

[Fred A Milton]

To me, Krauthammer's grasp of foreign policy issues, and most other issues, is unexcelled anywhere.

The clear-headedness of his writing is so persuasive and difficult to counter that it drives leftwingers like Brendan crazy, reducing them to spitting lame ad hominems.

One day one of them will stoop to calling the brilliant Dr Krauthammer a "hack psychologist" or something like that.

[Fred A Milton]

Sorry, I mean, "hack psychiatrist".

I always get those two mixed up.

[Fred A Milton]

Hello Dr X.

I followed your link, which was interesting. The section you indicated says, "...it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination...".

To assert that Krauthammer offered a professional psychiatric opinion about Obama within Krauthammer's once-removed and equivocal "sentimental reflexes" comment requires the asserter to crave desperately a way, no matter how absurd, to attack Krauthammer.

A superfluous question: What constitutes an "examination", in the meaning your linked resource intends?

[Dr X]

@ Fred A. Milton:

What constitutes an "examination", in the meaning your linked resource intends?"

It means meeting with the patient and conducting a formal diagnostic interview with the patient's consent. And as that paragraph also indicates, the psychiatrist must also have proper authorization to make a statement about the findings to anyone other than the patient.

That said, I wouldn't consider a comment about "sentimental reflexes" to be a psychiatric opinion. I don't think Krauthammer needs to worry.

[Fred A Milton]

Thanks, Dr X.