Thompson is not much of a diagnostician, and he legitimizes alot of his psychiatric namecalling by invoking the deprecated psychoanalyst Justin Frank, author of Bush on the Couch, who many of us feel violated an ethical canon of the field by diagnosing sight unseen (although I feel the the potential impact of the President’s mental stability or lack thereof on every living soul on the planet makes him fair game in a different way even than other public figures whose behavior is under scrutiny). Thompson’s other claim to the authority to bandy about the labels is his own status as a recovering alcoholic with 11 years sobriety. (“I know all too well the symptoms that Dr. Frank describes and, after watching Bush for the past several years, I have to, unfortunately, agree with him.”) Diagnostic acumen apart, if Bush’s behavior is really as Thompson’s putative White House sources describe it, we had better hope he is being attended to by a good psychopharmacologist. Not that we would ever know, since evidence bearing on the President’s mental health is a state secret, unlike the public status of the results of his annual physical. I would argue that the public has even more of an abiding interest in knowing about the President’s mental health than his physical, and that, if there is not, there ought to be some sort of periodic checkup in this sphere as well, the results being made public. (Bush’s own white paper on reforming the mental health delivery system in the United States, which I read in detail and wrote about in FmH last year, comes close to suggesting a mandatory annual mental health checkup for every citizen, in the interpretation of some, by the way…) Of course, someone as beady-eyed, petty and defensive as Dubya (and, uhh, that’s no psychiatric diagnosis, in case you were wondering) would take exception to such a requirement and fire any White House mental health professional who took their job responsibilities too seriously.

Review of Abducted: How People Come to Believe They Were Kidnapped by Aliens by Susan Clancy. Harvard University Press, $22.95:

I wrote about this story when it first broke in May and felt that the British mental health system was markedly remiss in terms of the lack of resources they devoted to his care. For someone the only clue to whose mysterious identity was that he appeared to be a composer and performer of captivating piano music to be treated by a staff whose knowledge of music could be summed up in statements like “I know it’s classical music, that’s all” (to paraphrase) and then to be transferred for internal reasons to a facility that did not even have a piano appalled me.

Now, at least according to a pulp tabloid ‘exclusive’, mental health treaters are reduced to name-calling. ‘Fakery’ is not a useful term to employ in this situation. We use the term “malingering” in psychiatry when a person deliberately, with conscious decision and purpose, simulates psychiatric symptoms for specific advantage. But it is a very difficult diagnosis to make, and one of last resort, even acknowledging that someone who malingers will always have the healthcare system (that is biased in favor of taking patients’ displays or reports of their distress at face value) over a barrel.

This patient’s actions over the ensuing months in the hospital themselves would seem to confirm, rather than disconfirm, that he is quite disturbed. Naive untrained staffs in mental health facilities often try to sort patients with disturbing behaviors into those who “can’t help it” and those who are “doing it deliberately” (so does the legal system when dealing with deranged behavior, trying to determine whether someone is “not guilty by reason of insanity” or “criminally responsible”) instead of realizing that there are all sorts of gradations of intentionality and all sorts of disturbances of the will. Instead of thinking about suing him for wasting their time, officials should examine their own seeming ineptitude in embodying that naiveté and in not getting to the bottom of this sooner. “Physician, heal thyself”, the saying goes, and also “Fool me once, shame on you. Fool me twice, shame on me.”

Discussion thread on The Onion‘s A.V. Club site about what movies people have walked out of. In almost each instance, they should’ve known better than to go to those dogs in the first place. Most are apologetic defensive about their choices and they deserve to be.