Evil Not Otherwise Specified

"And I looked, and behold a pale horse: and his name that sat on him was Death, and Hell followed with him."

Revelation

Enough for now with the rational exuberance of the election; let us be grimly realistic. The New Yorker this week has an intriguing look at the phenomenon of the psychopath, which, as the article reminds us, means "suffering soul." This brings up the obvious question of whether they themselves do in fact tend to suffer, as opposed to those who come in contact with them.

Those who, like me, do not work in forensic or correctional settings generally encounter antisocial types who are in distress of some kind (i.e. they present voluntarily for treatment). However, it seems to me that they are usually more perturbed by the social consequences of their actions than by those actions themselves. That is, they do, much like a severe substance abuser, seem to recognize at some level that they are not "right," at least not normal, but the distress comes about as a result of legal, financial, and social results of their behavior, which in itself they often find, of course, to be quite gratifying (or as we say in the business, ego-syntonic).

For instance, I saw a guy not long ago who was superficially quite pleasant and engaging but who professed to have committed a number of highly violent acts over the years, some of which had come to the attention of the legal system, some not. On one level, he seemed to exhibit remorse for this, but he was also at great pains (so to speak) to impress me with the magnitude of his potential for violence (he was affable with me and I did not feel directly threatened in any way). He said several times, "I don't want to hurt people," but at other times he acknowledged that hurting people sometimes gives him great pleasure, and he made a point of insisting that those whom he had victimized in the past had deserved it in some way.

This man did seem dysphoric, but I'm not sure that it was necessarily related to his antisocial style (he may have bipolar disorder as well). As the aforementioned article mentions, it is quite possible for psychopaths to function successfully and without obvious suffering. Psychopaths are not inevitably violent, and in settings such as business, law, or politics they may decide that it is in their best interests not to be, but the hallmark of the condition is that this decision is based purely on self-interest, not on true conscience.

A few decades ago, cultural explanations for the formation of antisocial individuals were dominant, reflected in the term "sociopath." The pendulum has very much swung back to neurobiological explanation. To be sure, many psychopaths have awful and abusive childhoods, but that may be due as much to genes shared with their parents as to any direct result of traumas endured (after all, most people abused as children do not become psychopaths).

Brain imaging is the reigning trend now for insight into behavior, but it's hard to know how this ultimately relates to whether we treat antisocial actions as freely willed or as imposed by psychopathology. After all, we know that all subjective experience and overt behavior originate in the brain in some fashion, and the precise location and nature of this--whether the amygdala or some other region lights up on functional MRI--is of questionable relevance to legal theories of responsibility. Of course, such theories ultimately reflect social consensus, and as brain imaging and other neurobiological techniques become more commonplace in the public eye, the trend over time may favor determinism over free will.

But there is a strong visceral resistance to viewing certain kinds of violent or predatory deeds as inevitable or merely biological. This may not be rational in a strictly scientific sense--as myriad philosophers have argued, from the point of view of the universe (or the ultimate functional MRI machine), all thoughts and behaviors are determined by the brain. However, our revulsion toward the psychopath is highly rational as itself a product of evolution.

One can imagine that genes favoring psychopathy may have survived over the eons because in some contexts they may confer survival advantage. In some situations ruthlessness and comparative lack of conscience, particularly when coupled with prudence, can be remarkably helpful. However, this has had to struggle against competing genes that have favored the social cooperation and trust that bound successful groups together over evolutionary time. Groups cannot function if more than a tiny fraction of its members are psychopaths.

A severely moralistic view of antisocial behavior has therefore, for both biological and social reasons, itself seemed inevitable so far. Whether psychopaths will continue to be "corrected" in the criminal justice system as they are now, or rather according to a mental health paradigm a la A Clockwork Orange (this remains science fiction, as no effective treatments for psychopathy currently exist), is based more upon social decree than upon science. It's for the voters to decide; the neurobiologists and the moralists will make their respective cases over time. The ultimate referendum: is the serial killer evil or sick?

The Case for Obama (Seriously)

King Lear: Dost thou know me, fellow?

Kent: No, sir; but you have that in your countenance which I would fain call master.

King Lear: What's that?

Kent: Authority.



Why have we hired Barack Obama for what The Onion called, half-seriously perhaps, "the worst job in the world?" We obviously did not hire him for his executive experience; rather, his appeal depends on leadership qualities, judgment, and temperament.

Obama inspires without having to rely on empty demagoguery or the "cult of personality." People are tired of the extreme partisan rancor that has taken over national politics for the past 15 years or so (I'm happy to admit that Democrats have contributed to this as well, but in my opinion less than Republicans). Obama has charisma and obviously uses it to achieve his aims (and he needed it to help win the election), but if anything he constantly downplays this characteristic. Recall that a year ago he was often criticized for being dry, aloof, and "professorial." As I've written before, unlike most politicians, Obama does not seem to need the adulation of the masses, but rather views it as a necessary means to political ends.

Obama is like Bill Clinton in that he is both charismatic and wonkish--he really does have a meticulous interest in getting things done; he is more pragmatist than ideologue. Unlike Clinton, he is also highly disciplined. He is a leader who inspires people to work their butts off for him, and as his flawlessly run campaign suggests, he is good at spotting talent. But he panders less than most politicians (it's probably impossible to get elected without pandering at all). After all, in his speeches he has spoken of personal sacrifice and "tightening our belts"--how long has it been since we heard that?

In terms of judgment, it is hard to overstate the significance of Obama's early opposition to the Iraq war in 2002, at a time when this was a minority opinion and a politically risky one. The war is finally wrapping up, and it has been overshadowed by the economy as has everything else, but it is good to remember that, despite the final "success" of "the surge," the war overall was the greatest tragic blunder of the Bush presidency. From the vantage point of 2002, Obama could have been disastrously (for his political prospects) wrong, but he wasn't.

In terms of general administrative skills, Obama endured, with remarkable grace and resilience, what may have been the longest (22 months) and most grueling single political campaign in American history. His operation was huge, involving all fifty states and, of course, hundreds of millions of dollars. The people he chose to run it did so with admirable unity and efficiency. Can even this huge campaign operation automatically be extrapolated to the massive extent of the federal government? Of course not, but it is a promising sign. Part of what we're after is sheer competence; after all, the Bush administration was so dismaying not merely because of ideology but also because of ineptitude (see Iraq War, Katrina response, etc.). And sure enough, in his first days Obama is not staffing his White House with eager but green 20-somethings; rather, he is looking to experienced political figures for wisdom. Also, how much foreign policy experience did Governors Clinton and Bush have when they took over?

I was slow to warm to Obama. A year ago I was saying that Hillary Clinton would make a better acting President (although I never did think she could win the general election--too much baggage). And until recently I had always had some admiration for John McCain (the last eight years would have been much different, and in a good way, if he could have bested George W. Bush in 2000). Indeed, as recently as a few months ago I was fairly complacent about the election because I figured we would get a decent administration regardless of the outcome.

But McCain's erratic behavior in the closing months, and his willingness to take the low road with negative campaigning (even if it wasn't as negative as it could have been), was alarming to me. It is good to remember that there really was no truly conservative choice this election season. Indeed, the Bush administration has been so objectionable because it hasn't been conservative; it has been radical, in its unilateralism, its extreme economic policy, and its disregard for consensus. McCain's increasing coziness with these Bush trends over the past couple of years, coupled with his "maverick" status, made me wonder what the heck he might do if given the most powerful position on earth? Palin was the last straw--not a "maverick" choice but rather a radical and reckless one--and showed me that McCain had finally gone around the bend. In fact, I try to avoid ageism, but his erratic behavior overall made me wonder, in a neurobiological sort of way, what exactly was going on in that 72-year-old brain.

In terms of experience, one can always revisit the example of Lincoln, who technically had less experience than Obama when elected. Lincoln probably was a risky choice at the time and could have turned out to be a disaster (why not just let the South go and leave slavery for the next generation?). But people clearly saw qualities in him that promised exceptional leadership and judgment. I'm definitely not saying Obama is another Lincoln, and he could certainly fail, or be a very qualified success like Bill Clinton. But I would argue that from the vantage point of the current time, he is overall the least risky, and the most favorable, choice we have.

Uneasy Lies the Head

Let me have men about me that are fat;

Sleek-headed men, and such as sleep o' nights.

Yond Cassius has a lean and hungry look;

He thinks too much; such men are dangerous."

Julius Caesar

1. As I consider the myriad "horse races" of the election season, it's easy to see Obama as a political version of Secretariat, running away from the pack at Belmont (the charming video of that race, easily found on Youtube, features the awestruck announcer famously proclaiming the great equine "a tremendous machine!" as he comes down the stretch).

2. Overshadowed by all the other election hubbub was the vote by the state of Washington to legalize assisted suicide for the terminally ill (joining Oregon, the Netherlands, Belgium, and Switzerland). As a psychiatrist who fervently values dignity and self-determination but who is all too aware of the distorting influences of even subtle depression, I have always found this a particularly tough issue to make up my own mind about. It is similar to my ambivalence about capital punishment; to point out the obvious, the very irrevocability of death casts a pall over even the strongest sense of the right. If it is possible to quote this in a broadly secular sense, the words of Oliver Cromwell come to mind: "I beseech you, in the bowels of Christ, think it possible you may be mistaken."

3. Speaking of the "bowels of Christ" (and Cromwellian insurgencies), Kay Hagan usurped Elizabeth Dole's North Carolina Senate seat despite Dole's immediately notorious campaign ad trying to smear Hagan's alleged association with the "Godless Americans" PAC. A Hagan-sounding voice at the end of the absurd spot cried out, hysterically, "There is no God!" The apparently devout Hagan objected vehemently to the misrepresentation of her piety, but nowhere around here did I come across any umbrage over the deeper implication, that to be "Godless" (it sounds even worse than "atheist") is in itself to be on a par with pedophiles or terrorists. I truly think that a woman, and then eventually a homosexual, will be elected President before an openly atheistic person could be considered.

4. I've always wanted to visit Alaska: so much space, so few people, the incredible terrain. The more I hear about Governor Sarah Palin and convicted felon Senator Ted Stevens, the more curious I become. In a collective expression of "up yours!" Stevens was apparently just voted back to Washington by the good people of Alaska, although that required a state-wide vote of only about 106,000 people (Obama could get that every time he held a rally). Nothing is more ironic than Palin touting the virtues of "real Americans." When I think of the latter, Anchorage doesn't, somehow, come immediately to mind. No, I still want to visit Alaska some day precisely because it is the Other in so many respects.

5. The other day I revisited Obama's vaunted 2004 Democratic National Convention speech. It was as great as I remembered, but I was struck by how very young he looked then. In current appearances he looks, to my eyes, ten years older; hopefully some of that is a transient effect of fatigue. The man is going to have to be strong. He is the first "celebrity" President since JFK, but that is a much more life-consuming role now than it ever was. Except for the occasional jaunt to Camp David or whatever, a celebrity President, unlike your regular celebrity, can't take refuge in eccentric isolation or furtive trips to rehab. Think of what happened to Bob Dylan when he felt the weight of a generation's hopes (okay, later he still managed Blood on the Tracks and Desire, not bad). To be sure, Bush got away to Crawford a great deal, but I don't think many noticed he was gone.

6. If one word could capture my association of Obama and our politics it would have to be intellectual and political class, not in the economic sense but in the sense of subtlety (without vacillation), self-respect (without smugness), and sophistication (without supercilious elitism). Mistakes will be made, but one hopes they will be earnest ones, rather than the boorish ones of the past eight years.

7. If anyone is Obama's Presidential "father" it is Hillary Clinton. The year-long inferno of the primary race singed off any weak or superfluous parts and completed his transformation into the ueber-politician (in the best sense of the word). If he were like most of us, he would, knowing how very much he owes her (and the dream of hers that was consumed in the same blaze), avoid her like the plague. I was afraid he might select her as running-mate just to show himself and the world that he is not like that. Fortunately he was so much not like that he could forgo advertising the fact, and instead could pursue his primary ambition. Similarly, he was merely being himself when he felt able to take the time to visit his dying grandmother without making a political issue of it. Like most geniuses, he supersedes distractions, including, and most importantly, psychological ones.

(The program is acting up and won't allow proper spacing, which is driving me crazy. All I can think of on short notice is to use some bold type for contrast--sorry).

Fiat Lux

"The worst lack all conviction
While the best are full of passionate intensity..."

Yeats (paraphrased)


It is disorienting to have a national leader who is curious, articulate, and gracious toward those with different views. It is like waking up with 10 more IQ points--and better manners besides.

I'm sure many are having similar reflections this morning, but in my 39 years the only two other instances of such profound change I can remember feeling in my gut this way were the break-up of the Soviet Union and 9/11.

I hope my children can grow up with eight years of this.

North Carolina "battleground" Dispatch

1. On rural roads down here one sees almost exclusively McCain/Palin signs; in the cities, of course, not.

2. Some 2.6 million people in North Carolina voted early, roughly 40% of registered voters.

3. It is chilly and rainy in central North Carolina this morning, but there was still a one hour wait at my rural precinct when it opened at 6:30 A.M.

4. At the end of the long line when polls opened, out by the parking lot, a fellow was handing out "sample ballots." They were ballots, alright, but except for the presidential race, which was unmarked, all of the other races were marked Republican. A handwritten note at the bottom helpfully explained that the marks reflected the "constitutionally correct" positions on several issues. When I emerged an hour later, he was gone.

5. Voter name and address were requested and were checked off in the book, but no I.D. of any kind was required. On the basis of such casual procedures the near future of the free world is decided...

Reality is Prodigy

"'Yes, we wait for the stroke of doom,' said Faramir. And they said no more; and it seemed to them as they stood upon the wall that the wind died, and the light failed, and the Sun was bleared, and all sounds in the City or in the lands about were hushed: neither wind, nor voice, nor bird-call, nor rustle of leaf, nor their own breath could be heard; the very beating of their hearts was stilled. Time halted."

The Return of the King

"'Whilst the last members were signing it,' wrote Madison, 'Doctor Franklin looking towards the Presidents chair, at the back of which a rising sun happened to be painted, observed to a few members near him, that painters had found it difficult to distinguish in their art a rising from a setting sun. I have, said he, often and often in the course of the session, and the vicissitudes of my hopes and fears as to its issue, looked at that behind the President without being able to tell whether it was rising or setting: But now at length I have the happiness to know that it is a rising and not a setting sun.'"

Miracle at Philadelphia

Vox Populi

"Reason may mislead us; experience must be our guide."

John Dickinson (of the Constitutional Convention)

In a few days we can finally think of something besides politics, but not quite yet.

1. Perhaps the greatest casualty of a for-the-ages McCain upset on Tuesday, after of course one Barack Obama, would be the credibility of countless pollsters and pundits, who have with rare near-unanimity virtually crowned Obama before the fact. In fact, I guess both polling as a "science" and political commentary as an art would be set back a fair piece if so many agreeing polls, and pols, could turn out to be wrong. Reliability (i.e. consistency and reproducibility) without validity (i.e. accurately describing the world as it is) gets you nowhere. If McCain wins, even psychiatrists will be able to hold their heads high for a change--around pollsters and pundits at any rate.

2. A couple posts ago I wondered about the nature of delusion. The ever helpful NYT features this article reviewing the strangely opposite (although equally vitriolic) political universes of Fox News and MSNBC. I wonder if the two channels in fact demarcate the limits of those political interpretations of this campaign that could be called, by consensus, within the normal range (and quite a wide range it is). Perhaps to be to the right of Fox, as to be to the left of MSNBC, is to exceed the two standard deviations that begin to raise the eyebrows of people like me (if, as ever, there is "functional impairment" as we say).

3. I was thinking more about the literary skills of Presidents, and it occurs to me that the last century or so has been a long relatively unlettered stretch (I'm no presidential historian though--where is Michael Beschloss when you need him?). Of the founders, Jefferson and Madison were writers and thinkers of the highest order. Another peak occurred with Lincoln and Grant (whose Civil War memoirs enjoy critical esteem).

Theodore Roosevelt and Woodrow Wilson were literary types who wrote extensively, although little that I know of that is of lasting general interest. After that, I can think of little except Kennedy's Profiles in Courage, but that book, even more than Obama's Dreams From My Father, is widely suspected to have had major ghostwriter input. I'm looking forward to seeing what the George W. Bush Presidential Library will have on display.

If anyone knows of other examples of superior Presidential writing I would be curious to know them.