It is still August, and therefore not too late for President Bush to have the second half of his medical check-up: psychological testing. After his press conference on Monday in which he kept talking about finishing the job while attacking Democrats for wanting an exit strategy, Bush showed even more telltale signs of a particular kind of mental disturbance which medical professionals call thought disorder.
He may be physically fit to do the job, despite his five pound weight gain. But he is not mentally fit - at least not until he is pronounced so by a group of examining psychiatrists who must do a thorough mental status exam as well as a battery of psychological tests, with special emphasis on his relationship to reality.
I had always felt that his inability to respond to crisis, as seen in his response to 9/11 and Katrina and Israel's bombing of Lebanon, was because he suffered from something called affective flooding, where overwhelming anxiety paralyzes any ability to think or even function. Such a response is similar to denial but writ large. Those who observe the president at such moments - thanks to smuggled film clips and his historic April 2004 press conference when he was asked if he had made any mistakes as president - see that he starts rapid blinking movements before his eyes glaze over and become almost fixed in a blank, mindless stare. This massive disconnection from inner self and outer world is called "splitting."
But his most recent press conference (August 21, 2006) showed that when he is in control he is not flooded in this way. Rather, his splitting takes the form of hatred of reality. I use the term hatred purposefully. When he was pushed by a few increasingly frustrated reporters, he behaves like the untreated alcoholic he is - summarily dismissing material reality.
When offered a chance to re-think the Iraq war he becomes obstreperous, using sarcasm to both mask and express his internal rage at being challenged. When back in control he patronizes members of what he calls the "Democrat" party, saying that they are "good people" and that he doesn't question their patriotism. In control he is a poor man's Cicero, saying what he's not going to say anyway. Reading between the lines, he calls his critics quitters.
All of this behavior is in the service of defending himself against reality - something he actively hates. At times, his attempts to ward off reality make him appear stupid. He is not. Rather, internal and external realities are too threatening for him to face. When asked whether he had been surprised or frustrated by all the bad news from Baghdad he didn't even understand the question. This is because the very act of facing such questions threatens to destroy his tenaciously held preconceptions. This he cannot risk; he employs various coping mechanisms to attack such questions in any way he can. Instead of acknowledging personal frustration he said that the war must be frustrating for the national psyche. But his hatred of reality required a more violent approach - the day after his conference he sent more of those poor marines back into a world of horror.
His ability to dismiss reality is profound - more than the simple method used by his mother Barbara, who said she wasn't going to watch the TV news during the war because watching body bags would spoil her "beautiful mind". No, he has a rugged inner strength - unless confronted by surprise - that enables him to dismiss and destroy personal perception.
His mental pulse needs to be taken, not just his physical one. I think that what prevents his doctors from doing so is their fear of what they'd find. Without such an examination, we are left with no medical terms to describe his mental functioning, his private global war on terror which extends to attacks on his own capacity to perceive reality. I have not examined the President, so it is not proper for me to offer a diagnosis. However, my observations lead me to believe that he is psychotic.