In the winter of 1949, the first secretary of defense, James V. Forrestal, announced his impending retirement from office.
The announcement was abrupt but not entirely unexpected. Columnist Drew Pearson had revealed that the 1948 Republican presidential candidate, Thomas E. Dewey, had met privately with Forrestal and had asked him to stay on if Dewey won the election. This was a serious annoyance to the winner of the election (and Forrestal’s boss), Harry Truman. And Truman’s principal campaign fundraiser, a Washington lawyer named Louis Johnson, was champing at the bit to succeed Forrestal at the Pentagon.
Once Pearson’s story had been published, Forrestal’s days in the Truman administration were numbered. But there was another reason as well. In 1940, Forrestal had been one of the dollar-a-year Wall Streeters recruited for the coming war effort by Franklin Roosevelt, and his rise had been prodigious. He had been a White House assistant and undersecretary of the Navy, and when Navy secretary Frank Knox died suddenly in 1944, Forrestal succeeded him. In 1947, when the armed forces were unified in a new Department of Defense, Forrestal became its first chief.
He had always been a tense, driven man—and now in his late fifties, ending a historic decade of burdensome service, was showing signs of what used to be called nervous exhaustion. So alarming, indeed, were his behavior and appearance that almost immediately after stepping down, he was flown to a friend’s estate in Florida for rest and recuperation. The change of scenery, however, seemed only to deepen his symptoms, and Forrestal was quietly transported to the National Naval Medical Center outside Washington for psychiatric treatment.
Two months after his retirement, Forrestal jumped to his death from the high-rise tower of the naval hospital.
I mention the case of James Forrestal not to suggest that there are any parallels with President Trump, whose stability and mental health are a source of constant speculation in the media, but to point out that the character and personalities of political leaders have been a subject of concern and inquiry for a very long time. In his pioneering study of Forrestal, the late historian Arnold Rogow declared that his subject’s tragic case “underscores the observation that we need to know much more about the tensions and frustrations of high office. . . . When the survival of civilization may depend upon sanity in high places, the question is especially urgent.” And that was in 1963.
There are two problems in endeavoring to answer that urgent question, however. To begin with, presidents are human beings and, as such, respond to the exigencies of the presidency as humans would. By modern clinical standards, Abraham Lincoln probably suffered from depression, as did James Madison, Calvin Coolidge, and others. The towering egotism—as well as the narcissism and mammoth intensity—that propels men into the White House can easily be mistaken for a host of pathologies. And in some instances, it may well be true: It should hardly be surprising that the poisonous character of partisan politics—the fishbowl, the derision, the aspersions, the pettiness—drives some presidents, perhaps all of them, a little crazy.
But that’s the other problem: Too often, the diagnosis is not scientific but political. Or to put it in colloquial terms, if there is an occupant of the White House who has not, at one time or another, been accused of lunacy, of having taken leave of his senses, or of suffering from some malevolent disease of the mind, I am unaware of it.
In our time, this has been true, in particular, of Republican presidents—and especially since publication of the notorious September-October 1964 issue of Fact, a short-lived investigative journal of the era. That was the occasion when Fact’s editor-publisher, a sometime pornographer-journalist named Ralph Ginzburg, polled several thousand American psychiatrists and found 1,189 of them willing to declare publicly that the GOP presidential candidate that year, Sen. Barry Goldwater, was “psychologically unfit to be president.”
Ginzburg’s stunt is unlikely to have had much effect on the outcome of the 1964 race, but it did prompt the American Psychiatric Association to amend its principles of medical ethics to declare that while psychiatrists may speak generally to the press about psychiatric matters with reference to figures in the news, it is unethical for members to offer professional opinions about people they have never treated. Moreover, it’s equally 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.”
The so-called Goldwater Rule, adopted after the senator successfully sued Ginzburg for libel, is medical common sense, and most physicians would readily subscribe to it. Yet it is useful to peruse the dozens of written statements reprinted in Fact. Many consist of long-distance diagnoses—“To me the outstanding sign of Goldwater’s instability is his radiation of diffuse but continuous hostility,” and “Goldwater’s mental instability stems from the fact that his father was a Jew while his mother was Protestant”—but most tell us more about the writers than about Goldwater.
Norma Mason, M.D., of Chicago, for example, revealed that “in my practice I have had . . . at least 10 ‘ham’ radio operators. The unique characteristic of all these people was an inability to communicate face to face with their fellow men without discomfort.” Meanwhile, Paul J. Fink, M.D., of Philadelphia averred that Goldwater “appeals to all of the delinquent tendencies in the citizens of the United States: bigotry, hatred, doing away with the income tax, etc.” In many instances, the very same symptoms that armchair analysts find in Trump—hatred, personal cruelty, delusional thinking, as well as character traits shared with Hitler and Joseph McCarthy—were also detected by Goldwater’s critics decades ago. Most revealing of all, the most common observation was that Goldwater’s right-wing political opinions were prima facie evidence of insanity and unfitness.
Which is precisely the point. There have always been social scientists who like to demonstrate that conservatism is, itself, a kind of social pathology and that people who identify as conservatives are, by definition, pathological. In this instance, the particular achievement of President Trump is that his (admittedly unconventional) behavior seems to have persuaded certain conservatives to adopt this doctrine as well. But it’s a minority opinion, at best, and those men and women of science willing to defy the Goldwater Rule tend to approach crank status.
Eli S. Chesen, M.D., for example, is much admired among some of Richard Nixon’s scholarly detractors for his 1973 volume, President Nixon’s Psychiatric Profile: A Psychodynamic-Genetic Interpretation, and the George Washington University psychiatrist Justin A. Frank, M.D., gave comfort to critics of the Bush administration with his Bush on the Couch: Inside the Mind of the President (2004)—helpfully updated three years later—which theorized that George W. Bush is a megalomaniac and sadist, whose status as what laymen call a “dry drunk” explains his chronic irritability and a rigid, “inflexible world view.”
As if to prove conclusively that there’s nothing new under the sun, last fall a Macmillan imprint published a collection of 27 essays, edited by a clinical professor of psychiatry at Yale, on Trump’s psychological unfitness for office. The editor, Bandy X. Lee, M.D., believes that Trump needs to be removed from office under provisions of the 25th Amendment, and most of the contributors share her opinion. But the arguments are largely the old one made a half-century ago against Barry Goldwater—Trump believes [fill in the blank] so he must be crazy—and essays by journalist Gail Sheehy and the left-wing linguist/foreign-policy guru Noam Chomsky do little to enhance the volume’s credentials.
In a curious way, Dr. Lee and her colleagues have adapted the old Soviet notion of mental health for American purposes. In the 1970s and ’80s, political dissidents in Russia were routinely incarcerated in mental institutions on the theory that anyone who chose deliberately to defy the regime and suffer the consequences must be insane. In America at the time, this was regarded by psychiatrists as a shocking abuse of professional standards; but politics makes strange bedfellows.
Of course, none of this is meant to argue for Donald Trump’s stability or even his fitness for office. But partisan politics in scientific disguise seldom succeeds as politics and insults science. For that matter, James Forrestal’s life and death remind us that the human mind is capacious and variable. And if Abraham Lincoln was clinically depressed, what does a clean bill of mental health mean to history?
