Monday, July 6, 2009

Sarah Palin's Personality Disorder Problem

Evidence of the overall cheapness of American political dialogue can be found in the news surrounding Sarah Palin--not in her announcement that she would be resigning her office, but rather in Todd Purdum's Vanity Fair article that may have contributed to the timing of her announcement. Purdum's article is for the most part a rehash of insider gossip about the tensions between McCain's advisors and Governor Palin during the campaign, and is remarkable only for the candor with which some of the political staffers spoke.

Among the unremarkable features of the article includes a little medical soliloquy, and it's unremarkable because we've seen this happen before in national political discussions. Purdum wrote:

More than once in my travels in Alaska, people brought up, without prompting, the question of Palin’s extravagant self-regard. Several told me, independently of one another, that they had consulted the definition of “narcissistic personality disorder” in the Diagnostic and Statistical Manual of Mental Disorders—“a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy”—and thought it fit her perfectly. When Trig was born, Palin wrote an e-mail letter to friends and relatives, describing the belated news of her pregnancy and detailing Trig’s condition; she wrote the e-mail not in her own name but in God’s, and signed it “Trig’s Creator, Your Heavenly Father.”

There it is--Purdum, who is in theory a journalist, includes accusations that Sarah Palin has Narcissistic Personality Disorder because "several people told" him, and apparently they read the Diagnostic and Statistical Manual for Mental Disorders (in the biz called simply the "DSM") and it looked to them like it fit. Within days of the article's release, TV and radio personalities as well as various websites began trumpeting the Governor's "diagnosis" basically assuming it was factually true; for instance, a Yahoo! news bit can be found here, while Salon's War Room (Billy is normally a fan) discussed it here.

This is prattling nonsense of the worst sort, with armchair diagnosis passing for professional opinion, and then repeated again and again as if it were fact. As if to substantiate his own claim, Purdum includes a lil' note from Palin on the birth of her child Trig, noting that it was signed "Your Heavenly Father." Is it a touch odd for Palin to sign the note thus? From my perspective, yes, but I'm an agnostic east-coast Jew so I'm not so sure whether or not this is just a cultural thing and perhaps passes for normal and heartwarming among Christians in Alaska. Does it indicate that Palin thinks--as the placement of this story in this particular paragraph suggests--that she is the Heavenly Father, or speaks directly for him? That seems like such a stretch to me that Purdum appears guilty of the worst kind of guilt-by-innuendo journalism that marks so much of political reportage these days.

For what it's worth, here is the current DSM definition of Narcississtic Personality Disorder:

The symptoms of narcissistic personality disorder revolve around a pattern of grandiosity, need for admiration, and sense of entitlement. Often individuals feel overly important and will exaggerate achievements and will accept, and often demand, praise and admiration despite worthy achievements. They may be overwhelmed with fantasies involving unlimited success, power, love, or beauty and feel that they can only be understood by others who are, like them, superior in some aspect of life.

There is a sense of entitlement, of being more deserving than others based solely on their superiority. These symptoms, however, are a result of an underlying sense of inferiority and are often seen as overcompensation. Because of this, they are often envious and even angry of others who have more, receive more respect or attention, or otherwise steal away the spotlight.

This, though, doesn't describe the features which distinguish personality disorders as a whole from the unflattering qualities that they represent. DSM elaborates on this, noting that to be diagnosed with a personality disorder, the following criteria must be met:

-Symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder.

-The history of symptoms can be traced back to adolescence or at least early adulthood.
-The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life.
-Symptoms are seen in at least two of the following areas:
Thoughts (ways of looking at the world, thinking about self or others, and interacting)
Emotions (appropriateness, intensity, and range of emotional functioning)
Interpersonal Functioning (relationships and interpersonal skills)
Impulse Control

Could this be a description of Sarah Palin? At absolute best, maybe. Since I have not known her for years, and I have not been involved in her life to the extent that I can assess whether her vanity has caused "significant distress or negative consequences in different aspects of [her] life," I don't feel remotely qualified to answer, and I suspect the same is true of the very people that Purdum relies on for his juicy tidbit. That said, I have yet to read an account of her that indicates that she acted megalomaniacally in her "Sarah Barracuda" days in high school so that we could establish this diagnosis, since this pattern of grandiosity must be present since no later than early adulthood. So I suspect this is a totally bogus "diagnosis."

Could Governor Palin be vain, vindictive, grandiose, have a sense of entitlement, and demand praise and admiration? Certainly--and I think there's plenty of evidence to indicate that at least some of these adjectives apply to her. But that doesn't give her the diagnosis of Narcissistic Personality Disorder. And Vanity Fair's Purdum (to say nothing of his editors), in blithely repeating these assertions from unnamed sources who almost definitely are not mental health professionals, attaches a clinical tag to her troubles. (Indeed, when considering this list of personal attributes and applying them to other politicians, President Obama's Chief of Staff Rahm Emmanuel has a reputation for being profoundly vindictive; one can find more than a whiff of vindictiveness in this story about how the White House is offended by one lefty Democratic congressman's willingness to call out the administration on what he believed was a lousy energy bill. Do they all have personality disorders as well?)

Liberal readers may recall that the shoe was on the other foot not too long ago, when then Senate Majority Leader and potential Presidential candidate (and, lest we not forget, actual physician) Bill Frist took to the Senate floor to pronounce his diagnosis that Terri Schiavo was not in a persistent vegetative state. At the time, the howls of indignation came from many corners, and rightly so: Frist was so far out of bounds as to deserve censure from his state medical ethics board in my opinion.

In Palin's case this is no less true. Nobody but appropriately qualified professionals should be bandying about diagnoses. Sarah Palin does not have a personality disorder; she does, however, have a personality disorder problem--the problem of snarky and shallow journalists shoving this kind of bilge on what appears to be an uncritical public.

I find Sarah Palin the politician contemptible in any number of ways. My principal objections to her is that she appears to be not merely uninformed but incurious, and she also appears to revel in anti-intellectualism. But I don't claim to know anything about Sarah Palin the person. From a distance I see a woman who made it to the position of Governor by her early forties--no mean feat, that--and has a family who appear to love her, whatever issues they may have (as all families do). I am perfectly willing to condemn any number of stands that she has taken since she has risen to political prominence. I am fearful of the prospect of a President Palin, although this happily seems to be increasingly unlikely. But I am not willing to go along with the idea that its okay for journalists to lazily repeat assertions of her supposed personality disorder.


  1. Excuse me, but journalists quote sources. That's what they do.

    Just because you are offended by people pointing out that Palin has a narcissistic personality disorder does not mean that Purdum is "lazy."

    And his sources are by no means the first peopel to notice that Palin has npd. Many, many others have too, which is why she earns ridicule.

    She exudes npd in her body language, in the calculating gleam in her eye, at the almost visible swelling of her head when she is applauded by crowds. It's a disorder very common to politicians and actors, including Sanford and Bloggo. John Edwards too.

    Regardless of their political pursuasion, journalists need to do a better job of highlightung npd in politicians, because such people have no business making public policy. They are not selfless enough.

  2. Oh really, Anonymous?

    Let me just make sure I have this straight: Palin has NPD because of the "calculating gleam in her eye"? Or the "visible swelling in her head when she is applauded by crowds"? Gosh, I guess I must have been playing ping-pong the day they went over those physical findings in medical school. You, apparently, were wired to your seat and had drunk a double-espresso before that lecture. And what a clinician you are! You have diagnosed NPD in not just Palin, but "Sanford and Bloggo [sic]. John Edwards too." You should bill for that, my friend! (But in the meantime, since I wasn't there, and am in general a fairly dim-witted doc, can you just point out how she earns that diagnosis using a strict reading of the DSM definition?)

    Excuse me right back, anon., but journalists who repeat third-hand gossip from disaffected souls who aren't trained in the diagnosis of mental health disorders and present it as fact are, in fact, exceedingly lazy. Purdum is more than within his right to quote his sources at length in repeating tales of the (still currently) Governor's vain, arrogant, and deceitful behavior if such behavior exists. But just because some yokels did a quick and shallow glance at the DSM and thinks it's a match (which, again, this here doc says it's not), Purdum and Vanity Fair are deeply irresponsible for allowing an unprofessional diagnosis into their article be presented as fact. If Purdum wants to make the claim that she indeed has NPD, he needs to find a shrink to say it out loud. (A shrink who knows her well enough to make the diagnosis. But uh-oh! If he has any professional contact with her that would be a violation of her privacy.)

    Regardless of their political persuasions, journalists need to do a better job presenting facts to their readers and not gossip. I used to like Rachel Maddow quite a lot but is she doing progressives any favors when she devotes more than 30 minutes of her show to the Mark Sanford saga while the healthcare bill is in danger of being scuttled? These are among the reasons why the state of our politics is so lousy; Purdum and yes, even Maddow, are just caught up in one big distraction after another. The joke is on all of us.