10/25/2008 05:12 am ET | Updated May 25, 2011

John McCain: Suffering from Irregularity

John McCain lurches from plan to plan, from statement to statement, from action to action. His behavior reminds me of my most manic patients when I was chief of the psychiatric in-patient ward.

Manic patients, now called bi-polar, are unable to manage their feelings, and their behavior is often at the whim of what they may be feeling at a particular moment. In order to justify their behavior they confabulate, make up a variety of lies in order to manage real and imagined questioning.

There are only two general character types who are chronically unable to manage an overwhelming tidal wave of emotion: people who suffer either from bi-polar disease or from pre-senile dementia. In both cases there is an over-riding or flooding of the brain, of the ability to think. One lurches from one quick solution to another.

This all adds up to an adult form of pathological lying - something children do when faced with anxiety, generally of the sexual variety. People who tell lies, like the ones McCain is currently telling, are ultimately lying to themselves about themselves. But his lurching from one desperate solution to another is even more troubling and demonstrates that he has no real plan for the country or this campaign, other than to attempt to derail those who oppose him.

McCain has favored de-regulation for his entire career, arguing that government should keep its hands off private enterprise and instead put faith in the free market. This approach hasn't worked and it also makes it hard for him to come up with innovative solutions - he is locked into one way of seeing things, one way of being. So when he suddenly calls for regulation he lurches in a new direction, but not with any substantive strategy behind the change.

What McCain is doing is trying to ridicule his own memory. Otto Fenichel, a disciple of Freud, wrote that a child might lie according to the following formula: "If it is possible to make people believe that unreal things are real, it is also possible that real things, the very memory of which is menacing, are unreal." This approach applies equally to George W. Bush and to John McCain. They are the masters of turning the past into something unreal - and Palin is their latest apt pupil with her oft-repeated "Thanks but no thanks" disclaimer of taking earmarks for the bridge to nowhere.

The final issue for McCain is not about economic regulation or deregulation - he needs to show some presidential self-regulation. He must demonstrate that he can take the time think through complex issues and provide real solutions to the serious problems we face. Being known as a maverick is no badge of honor and it's not a choice. He isn't running wild - he's running scared.