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An answer to Edith Efron's 1994 article, "Can the president think?"
In the November 1994 issue of Reason, Edith Efron asked the intriguing question: "Can the President Think?" Her conclusion was that the president suffers from severe cognitive dysfunction and that the resulting chaos of his mind accounts for the chaos in his administration.
In her analysis, Clinton emerges as the sum of two great paradoxes. He is the hollow Sun King, and he is forever sprinting in place. The first, refers to the strange emptiness that we perceive at the center of the charismatic Clinton phenomenon. The second, to the utter chaos that reigns at the center of his administration -- and, seemingly, of his mind.
In this essay, I will first present an outline of Efron's argument, along with her explanation of what makes Clinton tick. I will then present an alternative theory -- one that unifies not only these two paradoxes, but also the ugly reality of Clinton's other pathological behaviors.
The First Paradox: The Hollow Sun King
Clinton evokes worship as no American politician has since JFK. Not respect. Not admiration. Not even hero worship. But a sort of personal fawning, by both male and female worshipers, that borders on the sexual. For example, a youthful Arkansas journalist (a male) once described the fledgling Arkansas politician, Bill Clinton as
"the Sun King. And if you look too long at him you will be blind, your senses flooded with his gold-spined brilliance.... There must be some elemental undercurrent here that generates envy in other men, not just the musk of power but something pheromonic. Since it is not polite to compare your governor to Mussolini or even Huey Long, then let's say one of those Kennedy boys....
Actually, his choice of comparisons is strangely apt -- all of them. But, reluctant to leave Clinton in such company without explanation, he proceeded to call him "that rare thing, a soulful politician."
Yet a soul -- or at least a unifying "self" -- is exactly what many see as missing from this man. Not his enemies, who view him as evil, but his friends and supporters. Efron writes:
"Tom Rosenstiel of the Los Angeles Times, Chris Bury of ABC, Maureen Dowd of The New York Times, Richard Cohen of The Washington Post, and Joe Klein of Newsweek have all... reached a similar conclusion -- that Clinton is 'in hiding' (Cohen); that Clinton is a multifaceted being without a unifying self (Klein); that he is whatever you happen to be looking at or, as Bury resignedly put it, 'what you see is what you get.' Dowd, the most literary, climaxed a fusillade of contradictions by saying, 'In the end, the focus is the unfocusability.'"
His own closest aide, George Stephanopolous likened him, as reported in Woodward's "The Agenda," to "a kaleidoscope. What you see is where you stand and where you're looking at him. He will put one facet toward you, but that is only one facet." Some journalists, writes Efron, have
"looked behind the self-contradictory mosaic and reached the grim conclusion that Clinton has no 'self.' In his book, Strange Bedfellows, which describes the coverage of the presidential campaign of 1992, Rosenstiel writes: 'Like many politicians Bill Clinton is a man of unfinished and contradictory character--scholarly and shallow, outgoing and shy, principled and craven, the mood depending on the motive. He possesses extraordinary talent and a fierce thirst for knowledge and insight, but above all approval. One reporter who spent time with him in New Hampshire found him one of the most outwardly directed people she had ever met--as if he had little inner sense of self at all.'"
Sam Smith, editor of Progressive Review and an outspoken critic of Clinton from the left, has succinctly captured the essence behind the first paradox:
"It was the normal work of the politician, but with Clinton there seemed too much. Too many hands, too many friends, too many words, too many hours before he went to sleep, too many hours on C-SPAN solving the nation's problems with too many industrialists and economists--and in the end too little else. It was as though he were afraid that if he excused himself from the public eye he might no longer be real."
He is not real. Efron writes of the fragment of stone at the bottom of Stephanopolous' kaleidoscope -- reflecting in a unique way, showing a different facet to each person as Clinton turns. This is a metaphor for the elusive "real Clinton;" but, in truth, there is no real Clinton that we could possibly comprehend. That little fragment is so alien that it might as well not exist in our universe. At the core of this man, Clinton, where the soul is supposed to be, there is, instead, a gaping void. A black hole. The Sun King exists only as the irresistible gravitational pull he exerts on others and the dying light -- the catastrophic annihilation -- of everyone and everything that strays too close to his event horizon. Within, there is an unknowable emptiness.
The Second Paradox: Sprinting in Place
The second paradox is that Clinton does too much, too fast and so never does anything at all. As Efron writes:
"For some 15 years Clinton has been saying, over and over again, to people who have repeated it over and over again, that his problem is that he does 'too much, too fast.' Simultaneously, he has been ceaselessly reported to be an astoundingly slow worker who takes months to make a decision. Both cannot be true. And both are not true.
But it takes a long time to understand the gross contradiction between what Clinton says of himself and what the press has reported, because the answer is buried in a mysterious conflict deep inside Clinton's mind....
"...His mind races, ideas rush in on him with great speed; he fails to distinguish between having an idea and taking an action, between thinking and doing; he gets lost in details, so he cannot retain his abstract purposes; and he has great difficulty in reaching conclusions or making decisions."
Clinton is a man with a photographic memory and a penchant for details. A man who lacks totally the ability to apply practical logic to the business of making decisions or even of ordering priorities. He is a man, in short, who does not know how to think.
"Clinton's cognitive paralysis... affects others, it affects Clinton himself, and ultimately it affects his presidency. The most visible effect, which has appalled the political-media establishment, is the disorder that reigns at the White House. In the course of the publicity debut of The Agenda on 60 Minutes, Mike Wallace said incredulously to Woodward, 'Chaos?' And Woodward replied unsmilingly, 'Chaos. Absolute chaos.'"
Efron has done a profoundly important service by documenting these paradoxes, particularly the second. The president's job, after all, is to make decisions and to apply reason to intractable problems. Efron's thesis is that Clinton's mind works only with the assistance of prosthesis -- in the form of his wife, Hillary, or, to a lesser extent hired guns from outside his circle of sycophants.
However, Efron goes off the rails in the second half of her essay when she attempts diagnosis. She fails, in the final analysis to explain the first paradox. She misdiagnoses the second, omitting from consideration contradictory traits. And she fails to reconcile the two paradoxes into a single coherent portrait.
"...Clinton's defenses against pain and suffering are almost universally observed. Because all are tied to, if not solely caused by, his cognitive deficiencies, and because they have had dreadful effects on his presidency, I'll list three of them. You know them already:
"* Clinton values work and productivity, but only as a means to status and power. By his own say-so, he has valued nothing more than status and power since he was young. He is always aware of his relative status in power relationships. And he is extremely sensitive to criticism, especially if it comes from people with high status and power. His record of 'caving' under pressure, of betraying both principles and people, is due most fundamentally to his lack of confidence in his own mind. In the face of an array of power, he capitulates. He has betrayed every significant group in the Democratic party and numerous friends to win favor with their enemies. The loyalty he commands from his natural political allies is paper thin.
"* Clinton's mind is out of control. He has an unusually strong need to be in control of factors outside of him. When he is unable to control others, he grows angry, although the anger is usually not expressed directly. His entire relationship with the national press has been a covert battle for control, and it has been far more intense than you may know. See Tom Rosenstiel's Strange Bedfellows for a shocking report on the spying by the Clinton campaign on the national press during the presidential campaign.
"* Clinton's perfectionist demands, which delay and inhibit his decision making, are due in great part, as Lloyd Bentsen says so diplomatically, to his intellectual 'doubt.' Clinton is inordinately afraid of making mistakes. He is in so far over his head, over his capacity to do the work required for the presidency, that he exists in a state of terror. It apparently builds up in the night, and, according to Woodward, the next morning he vomits out the accumulated terror all over George Stephanopoulos in the form of uncontrolled explosions of rage. Clinton's eyes bulge, his face grows scarlet, he yells, he screams, he shrieks. While Clinton is quite capable of controlling this rage and conceals it from the public--it has only been glimpsed by accident and briefly--he does not control it in private. According to Meg Greenfield, he takes his rage out on vulnerable members of his family and on employees--on those over whom he has power.
"Stand back and look at all these defenses against pain and fear: Clinton is traitorous. Clinton is a devious manipulator. Clinton grovels before the powerful. Clinton bullies the weak.
"These are the attributes of Clinton that are known in both his public and his private life to those he has conned and betrayed. They co-exist with what Joe Klein calls 'his relentless huggy, weepy emotionalism' -- and relentless is a significant word. Huggy and weepy in this pale-eyed man with the eternally crooked smile are also manipulative weapons.
"These do not begin to exhaust Clinton's defensive repertoire. But they are enough to explain waning political support. All of the epistemological problems and all of the emotional defenses... are too well known for Clinton to win sustained respect.
When [Clinton] recites monotonously that he tries 'to do too much, too fast,' or that he sometimes 'works hard but not smart,' he is actually saying, 'I am very intelligent. I work terribly hard. I am not slow, I am fast. I think and I work with great speed.' It seems painfully clear that with those words Clinton is denying his cognitive paralysis and is asserting his self-worth....
She concludes from this that Clinton suffers from something much akin to obsessive and compulsive disorder. In fact, she refers to a comment Clinton made to a journalist about an episode in his life when he and his entire family went through counseling sessions following the conviction of his brother for drug trafficking: "I finally realized how my compulsive and obsessive ambition got in the way." Efron believes that
"[t]here is no reason to doubt that Clinton was diagnosed as being 'compulsive and obsessive,' since that is what journalists have been documenting since Clinton entered the White House.
"All of Clinton's thinking problems and emotional defenses described in this article are symptoms of Obsessive Compulsive Personality Disorder as identified by the American Psychiatric Association....
"The diagnostic literature says that at least five of the criteria of Obsessive Compulsive Personality Disorder must be present to identify someone as suffering from this disorder. Here are five that describe Clinton:
1. Perfectionism that interferes with task completion, e.g. inability to complete a project because [the person's] own overly strict standards are not met.
2. Preoccupation with details... to the extent that the major point of the activity is lost.
3. Unreasonable reluctance to allow others to do things because of a conviction that they will not do them correctly.
4. Excessive devotion to work and productivity to the exclusion of leisure activities and friendships.
5. Indecisiveness: decision making is either avoided, postponed, or protracted, e.g. the person cannot get assignments done on time because of ruminating about priorities."
Any given constellation of traits can be superficially consistent with a number of different disorders. The American Psychiatric Association's definitions of these disorders refers to "differential" diagnoses, incompatible alternatives. It is not enough to establish a positive match; one must also exclude the possibility that an alternative diagnosis is a better match. In the case of obsessive compulsive personality disorder, there are two such alternatives listed which do provide a closer match to the entire constellation of Clinton's behaviors.
Efron paints a moving portrait of a man in profound agony at his own cognitive imperfections. A man in emotional pain because he cannot think. A man driven by his fear of failure or of imperfection to spin forever just short of completion. She has it exactly backwards! Clinton cannot think precisely because he cannot feel. He has virtually no emotional life. And an obsessive compulsive's perfectionism arises from a hyperactive "conscience." But Clinton's conscience problem is that he has absolutely no conscience at all. Clinton is what I will call an adaptive psychopath, borrowing the term from "Manufacturing Social Distress," by Robert Reiber of CUNY.
Narcissistic personality disorder and anti-social personality disorder are two alternative, and preferable, diagnoses consistent with the traits Efron attempts to explain. These two are differential disorders to obsessive-compulsive disorder, but related disorders to each other. Psychopathy is, actually, just an older name for anti-social personality disorder. In the 1920's, psychologists adopted "sociopath" to replace "psychopath." More recently, the name "anti-social personality disorder" replaced the replacement. I intend to use "psychopath" as expressing more of, quoting Reiber, the "awe, horror, and perplexity" that these people evoke. To better capture a "phenomenon so spectacularly alien that it seems almost incredible that such people can exist." As for narcissistic personality disorder: all psychopaths (I suspect) are narcissists, although not all narcissists are true psychopaths.
Let me outline briefly the classic description of the psychopath from a short piece I wrote recently and called, somewhat tongue in cheek, "How to Spot a Psychopath, a Voters' Guide." It draws heavily on Hervey Cleckley's ground breaking work, "The Mask of Sanity."
"General poverty in major affective reactions."
The psychopath, Cleckly says, "always shows general poverty of affect. Although it is true that he sometimes becomes excited and shouts as if in rage or seems to exult in enthusiasm and again weeps in what appear to be bitter tears or speaks eloquently and mournful words about his misfortunes or his follies, the conviction dawns on those who observe him carefully that here we deal with a readiness of expression rather than a strength of feeling."
Cleckly describes the "emotional poverty, the complete lack of strong or tragic feeling universally found in all the psychopaths personally observed...." He expresses bewilderment at some literature that ascribes to them "powerful instinctual drives and passions.... Although weak and even infantile drives displaying themselves theatrically in the absence of ordinary inhibitions may impress the layman as mighty forces," he chooses to be charitable to experienced psychiatrists and suggests that they must be referring to some other type of disorder. The irony is thinly veiled.
"Specific loss of insight."
Cleckly asserts that the psychopath "lacks insight to a degree seldom, if ever, found in any but the most seriously disturbed psychotic patients." [I]n the sense of realistic evaluation, the psychopath lacks insight more consistently than some schizophrenic patients. He has absolutely no capacity to see himself as others see him.... [H]e has no ability to know how others feel when they see him or to experience subjectively anything comparable about the situation. All the values, all of the major affect concerning his status, are unappreciated by him."
Cleckly expresses astonishment at this in view of the "psychopath's perfect orientation, his ability and willingness to reason or go through the forms of reasoning, and his perfect freedom from delusions or other signs of an ordinary psychosis." Later he notes that "[s]uch a deficiency of insight is harder to comprehend than the schizophrenic's deficiency, for it exists in the full presence of what are often assumed to be the qualities by which insight is gained. Yet the psychopath shows not only a deficiency but apparently a total absence of self-appraisal as a real and moving experience."
Instead of facing the facts that lead to insight, the psychopath "projects, blaming his troubles on others with the flimsiest of pretext but with elaborate and subtle rationalization." He may, from time to time, "perfunctorily admit himself to blame for everything and analyze his case from what seems to be almost a psychiatric viewpoint, but we can see that his conclusions have little actual significance for him.... The patient seems to have little or no ability to feel the significance of his situation, to experience the real emotions of regret or shame or determination to improve, or to realize that this is lacking. His clever statements have been hardly more than verbal reflexes; even his facial expressions are without the underlying content they imply."
"Superficial charm and good 'intelligence''
A typical psychopath makes a very good first impression. He is perceived as bright, well adjusted and as manifesting "desirable and superior human qualities [and a] robust mental health." Despite this, "the psychopath's inner emotional deviations and deficiencies may be comparable with the inner status of the masked schizophrenic."
Actually, an unreliable unreliability. "The psychopath's unreliability and his disregard for obligations and for consequences are manifested in both trivial and serious matters, are masked by demonstrations of conforming behavior, and cannot be accounted for by ordinary motives or incentives. Although it can be confidently be predicted that his failures and disloyalties will continue, it is impossible to time them and to take satisfactory precautions against their effect. Here, it might be said, is not even a consistency in inconsistency but an inconsistency in inconsistency."
"Untruthfulness and insincerity"
"The psychopath," says Cleckley, "shows a remarkable disregard for truth and is to be trusted no more in his accounts of the past than in his promises for the future or his statement of present intentions." He is "at ease" and "unpretentious in making promises or denying culpability. His words in such matters carry "special powers of conviction.... Candor and trustworthiness seem implicit in him at such times. During the most solemn perjuries he has no difficulty at all of looking anybody tranquilly in the eyes."
When detection of wrongdoing is at hand, a psychopath may "appear to be facing the consequences with singular honesty, fortitude and manliness." But this, too, is a facade. "It is indeed difficulty to express how thoroughly straightforward some typical psychopaths can appear. They are disarming not only to those unfamiliar with such patients but often to people who know well from experience their convincing outer aspect of honesty."
Upon being discovered in "shameful and gross falsehoods, after repeatedly violating his most earnest pledges, he finds it easy, when another occasion arises, to speak of his word of honor, his honor as a gentleman, and he shows surprise and vexation when commitments on such a basis do not immediately settle the issue."
"Lack of remorse or shame"
A psychopath shows "almost no sense of shame. His career is full of exploits, any one of which would wither even the more callous representatives of the ordinary man. Yet he does not, despite his able protestations, show the slightest evidence of major humiliation or regret." However, the psychopath may, when cornered, seem to accept blame and express profound regret. But "subsequent events indicate that it is empty of sincerity -- a hollow and casual form...." His manner of delivering these perfunctory expressions will reveal nothing of this hollowness but will be "exceedingly deceptive and is very likely to promote confidence and deep trust." Which will soon prove to have been misplaced.
"Poor judgment and failure to learn by experience"
On theoretical matters, the psychopath may show superb judgment. On very complex ethical, moral or emotional issues he may also show excellent reasoning ability -- as long as they are abstract and do not involve himself as a participant. But about his own life, a psychopath demonstrates over and over an inability to learn from experience or to be deterred by punishment.
"Pathological egocentricity and incapacity for love."
The egocentricity of the psychopath "is usually of a degree not seen in ordinary people and often is little short of astonishing." However, a skillful psychopath may learn to camouflage it to suit his schemes. It is a "self-centeredness that is apparently unmodifiable and all but complete.... [I]t is an incapacity for object love and... this incapacity... appears to be absolute."
A psychopath may be capable of "casual fondness, of likes and dislikes, and of reactions that, one might say, cause others to matter to him." These are, however, "always strictly limited in degree" and "durability." And "[w]hat positive feelings appear during the psychopath's interpersonal relations give a strong impression of being self-love." He has "absolute indifference to the financial, social, emotional, physical, and other hardships which he brings upon those for whom he professes love...."
"Sex life impersonal, trivial, and poorly integrated"
"The psychopath's sex life," says Cleckley, "invariably shows peculiarities." There is not a strong congruence with any specific sexual deviancy, but deviance is not unusual and should not be surprising "in view of the psychopath's notable tendencies to hit upon unsatisfactory conduct in all fields and his apparent inability to take seriously what would to others be repugnant and regrettable."
Also not surprisingly, "in view of their incapacity for object love, the sexual aims of psychopaths do not seem to include any important personality relations or other recognizable desire or ability to explore or possess or significantly ravish the partner in a shared experience." They are generally limited to "literal physical contact and relatively free of the enormous emotional concomitants and the complex potentialities that make adult love relations an experience so thrilling and indescribable."
Far from being super-sexed, "their amativeness is little more than a simple itch and that even the itch is seldom, if ever, particularly intense."
As for the psychopathic male, "despite his usual ability to complete the physical act successfully with a woman, [he] never seems to find anything meaningful or personal in his relations or to enjoy significant pleasure beyond the localized and temporary sensations."
Psychopaths of both genders have a record of sexual promiscuity, but this "seems much more closely related to their almost total lack of self-imposed restraint than to any particularly strong passions or drives. Psychopaths sometimes seem by preference to seek sexual relations in sordid surroundings" or with inappropriate people. They go out of their way to find sexual entanglement that "mock ordinary human sensibility or what might be called basic decency...."
The male psychopath, beneath "his outwardly gracious manner toward women and his general suavity and social charm... nearly always shows an underlying predilection for obscenity, an astonishingly ambivalent attitude in which the amorous and excretory functions seem to be confused. He sometimes gives the impression that an impulse to smear his partner symbolically, and even wallow in sordidness himself, is more fundamental than a directly erotic aim, itself hardly more to him than a sort of concomitant and slightly glorified backscratching."
"Inadequately motivated antisocial behavior"
"He will commit theft, forgery, adultery, fraud, and other deeds for astonishingly small stakes and under much greater risks of being discovered than will the ordinary scoundrel. He will, in fact, commit such deeds in the absence of any apparent goal at all."
"Unresponsiveness in general interpersonal relations"
A psychopath does not feel genuine gratitude for kindness or trust. Nor does he conduct his life by any recognized code of reciprocity. But "we often find him attentive in small courtesies and favors, often habitually generous or quasi-generous when the cost is not decisive." Sometimes these acts are self-serving in subtle ways, but not always. "Outward social graces come easy to most psychopaths, and many continue, throughout careers disastrous to themselves and for others, to conduct themselves in superficial relations, in handling the trivia of existence, so as to gain admiration and gratitude. In these surface aspects of functioning, the typical psychopath (unlike the classic hypocrite) often seems to act with undesigning spontaneity and to be prompted by motives of excellent quality though of marvelously attenuated substance."
"Fantastic and uninviting behavior with drink and sometimes without"
Substance abuse is notoriously common with psychopaths.
"Failure to follow any life plan" or inclination toward risky, career threatening behavior
The study of psychopaths has been concentrated in prisons and psychiatric hospitals. Therefore there has been a tendency to equate psychopathy with an aimless life pattern. Today, however, there is an increasing interest in the "successful psychopath." One who is capable of establishing a goal and has the drive to achieve it -- at all costs.
Cleckley describes, in connection with the unsuccessful psychopath, the "gratuitous folly" with which he often trips himself up. Such reckless and irresponsible behavior may also be manifested by the successful psychopath, but he is better at talking or buying his way out of the trouble.
A genius for manipulation
This is my contribution, but it well documented both by Cleckley and Hare. There has been much study of the psychopath's side of his interpersonal relationships, but not enough, it seems to me, of his victims. The psychopath seems to possess a unique gift for manipulating people. Psychopaths make great con men.
My own theory is that, unencumbered by emotions, the psychopath is free to study his prey with analytical detachment. To learn what makes him or her tick. A professor of psychiatry with whom I discussed this had two additional explanations. First, he suggested that psychopaths pick impaired victims of the sort they can manipulate. Of course, this implies an ability to select susceptible prey. Second, he pointed out that a psychopath often succeeds in his swindles and lies by the sheer brazenness of his conduct. It defies the expectations of any reasonable man or woman and lies so far outside their comprehension that they fail to expect it before it happens or see it for what it is after it happens.
There is a clear match between the hidden life of William Jefferson Clinton, as we are beginning now to glimpse it, and this description of psychopathy. It is impossible to accept Efron's diagnosis of an obsessive-compulsive personality and then explain Clinton's other, clearly psychopathic traits. Efron's dramatic depiction of inner anguish and strife simply cannot apply to a creature endowed with virtually no insight, emotional life or conscience. But, as I hope to prove, it is possible to accept a diagnosis of psychopathic personality and then explain fully and elegantly both paradoxes noted by Efron -- and much more.
Efron's excellent and convincing portrayal of the hollow Sun King, which provides us with the first paradox, is an almost perfect description of a charismatic psychopath: a soulless "intraspecies predator" (to quote Hare's "Without Conscience"). A robot without empathy, devoid of conscience or remorse, living a mere shadow of an emotional life, but able to mimic the outward manifestation of emotions on demand. Able, therefore, to manipulate the unwary to a degree that defies imagination. Presenting a different facet to each viewer. Objectively hollow, but, to the susceptible, very like a "Sun King."
The second paradox, which arises from the total chaos at the center of Clinton's mind, is what brought Edith Efron to consider obsessive-compulsive disorder. I will now undertake to demonstrate that psychopathy is consistent with the cognitive dysfunction at the heart of this second paradox. I intend to do even better than that. I hope to prove that psychopathy, which is essentially an emotional (and moral) deficit, actually explains Clinton's cognitive dysfunction as described by Efron.
The trait at the root of psychopathy is flattened affect, a shallow emotional life. From this, all else follows. But three reported aspects of Clinton immediately come to mind to contraindicate such an emotional deficit: his "his relentless huggy, weepy emotionalism," his legendary screaming fits and purple rages and his repetitious self-diagnosis. Each one of these, as we shall see, is actually a manifestation of psychopathic dissociation.
A number of observations: First, psychopaths often are motivated by a need for approval. This is one reason they so carefully ape genuine emotional responses. Second, most, if not all, psychopaths also seek out opportunities to dominate others. This, and not hypersexuality, is why many psychopaths are sexual offenders. (Perhaps, in a way, they sense the emotional emptiness within and seek out extreme situations to fan the dim embers of their somatic experience.) Third, as Cleckley points out, it is an error to mistake the dramatic show of external emotion for a sign of a deep emotional states. With the psychopath it is always the result of either adaptive behavior or of weak inhibitions and a lack of empathy for the victim. Fourth, an intelligent psychopath is not oblivious to objective signs of his failures. He is, lacking insight, just oblivious to his own contributing faults. So a psychopath will often lash out at others in violent rage, blaming them for falling polls, failed legislation, editorial criticism, etc. And fifth, in connection with Clinton's frequent, "robotic," acceptance of fault in trying to do "too much, too fast": psychopaths are able to display faux insight when it suits them. They can analyze their own conduct with great psychological skill, but the words are, as Cleckley pointed out, as empty as are they.
Psychopaths are not hypocrites. They may or may not actually believe what they say when they say it. It hardly matters. They invest no emotional capital in it one way or another. They have none to invest.
A young patient cited by Cleckley had a typical history of truancy and delinquency. Finally, in desperation, his affluent family asked a friend to intervene. The friend was an older man with considerable practical experience helping troubled youths. He decided to take the boy on a long automobile trip -- with the purpose of maintaining a relaxed atmosphere while keeping his audience captive. The boy did most of the talking. He analyzed his own shortcomings with, seemingly, great insight and honesty. He volunteered that he needed to change and outlined steps that he might take to do so. The older man was very impressed. When they arrived back at the boy's home that evening, the man discharged his passenger at the curb and drove off. The boy walked past the house, through the back yard and out the back gate. He was next seen a week later, in police custody, having committed a spate of forgeries and thefts.
Was the boy aware that he was conning the old man? Who knows? Perhaps he was; perhaps he was not. We will never know and neither, in all probability, did he.
Let me offer as another "case study" a purely fictional account of the chance meeting of two psychopaths from the film, Freeway (a very black comedy). A young runaway girl from a completely dysfunctional household steals a car from her caseworker and set off down the California freeway. Her car breaks down. A sympathetic, middle aged passerby picks her up. He is a social worker at a school for troubled boys. With astonishing rapidity he breaks down her barriers and gets her to talk about her family and her problems. "Bob," she says in awe, "I trust you more than anyone else in the world." She has been with him less than an hour.
Suddenly, under the guise of rough therapy, he begins to abuse her verbally. She rebels and tries to get away. Her benefactor is now revealed to be the serial murderer we have heard reported about on the radio, who preys on young girls along this stretch of the freeway. Apparently, he also rapes them -- it seems, after they are dead. This apparently upsets the girl more than either her impending rape or death. Sitting next to him in the front seat, she pretends to have difficulty removing her panties, as he has commanded, and starts unlacing her boots. This brings her handbag within reach. She grabs a pistol from the bag and leaps into the back seat, holding the gun against the man's head.
With comical suddenness, the brutal expression on the man's face fades and he begins to sob piteously. "You are scaring me!" He moans. "I know now that what I did was wrong. I am a very sick man. I need help. I see that now. Let me go and I'll never do it again." This scene is, perhaps, the finest depiction on film of the psychopath's uncanny ability switch masks almost in mid-sentence as the situation demands. And of his knack for manipulating others through the false portrayal of emotion and, even, shame.
This time, however, it does not work. The girl -- later diagnosed as a psychopath, herself -- is not fooled. She orders the man to pull off the road. "Bob," she asks after much contemplation, "I have one important question for you."
"Stop, you're scaring me," he pleads.
"Bob, do you accept Jesus Christ as your personal savior?"
One sees in his eyes that he is weighing the consequences. After some vacillation he finally blurts out; "Yes. Yes, I do."
"Good, Bob." She says and shoots him in the head. This is, by the way, the beginning of the film and only the first of his attempts to kill the girl and the first of her shots at killing him.
Psychopaths have, for the most part, been studied in prisons. These studies tend to describe the life patterns of losers -- men and women incapable of maintaining a "normal" life. These people have seemingly intact intellects -- may, in fact, be of superior intelligence. However, on practical matters involving themselves, they are totally unable to plan or make sound decisions. Usually, given the population being studied, this is manifested in an aimless pattern in their lives.
Recent research tells us how an emotional deficit can manifest itself as such cognitive dysfunction. In 1994, Antomio R. Damasio (Ph.D., M.D.) published a seminal work on the profound interrelatedness of our intellectual and emotional processes, "Descartes' Error -- Emotion, Reason, and the Human Brain."
He started with a study of one Phineas Gage. In 1848, Mr. Gage was involved in a mining accident in which he blasted a sharpened sixteen foot iron rod, completely through his left prefrontal cortex. It landed some 100 yards away. He recovered consciousness almost immediately and was taken to town on a wagon. He walked unassisted to a nearby porch and sat patiently waiting for the physician, regaling his audience with the story of his accident. His brain was clearly visible pulsing beneath the horrible wound. Except for blindness in one eye, he recovered with no obvious mental or physical incapacity.
But he was not the same affable, hardworking, honest man that Phineas Gage had been before. He was completely changed. He could no longer hold a job. He became irritable and aggressive. His emotional life was shallow. He drank and brawled. And he displayed no ability to make intelligent decisions about his own life. His life spiralled downward from one personal disaster to another.
Gage's wound had deprived him of something besides his left eye. Something subtle. It had taken affect from him; it had stolen away his emotions. And for some reason, this produced a profound cognitive dysfunction that destroyed his life.
Damasio studied the Gage case (his wife, herself a neurologist, reconstructed the damaged brain from the skull, which is on public display), and he, himself, saw many living patients with similar -- although less dramatically sustained -- trauma to the prefrontal cortex. All suffered serious lowering of affect with no direct physical damage to their motor or language capabilities. And most manifested a similar severe impairment of practical intellectual capacity: they were unable to reason about things that had a bearing on their own lives (as opposed to purely theoretical puzzles) and were incapable of making rational decisions.
Allison Barnes and Paul Thagard (of the University of Waterloo in Canada) write in a paper called, "Emotional Decisions":
"Damasio maintains that Gage and other frontal lobe patients with faulty decision making skills have all the information required to make decisions. According to neurological studies by Saver and Damasio (1991), social knowledge in these patients remains intact. Their experimental subject, EVR, could provide response options to social situations, consider the consequences of these options and perform moral reasoning at an advanced level. EVR had normal or better intelligence and memory. Detailed studies by Saver and Damasio suggest that even with all the necessary information, such patients are unable to implement a choice in everyday life. For example, EVR would take hours deciding where to dine by obsessing about each restaurant's seating plan, menu and atmosphere. Even then, he could not reach a final decision."
Compare EVR's dilemma with Efron's descriptions of Clinton's frenzied and unsuccessful decision making.
Damasio's neurological studies show, write Barnes and Thagard, that
"what is damaged in these patients is not memory or intelligence, but the neural connections between the emotional and cognitive centers of the brain. More specifically, the ventromedial frontal region is reported to be responsible for emotional processing and social cognition through connections with the amygdala and hypothalamus. After a series of tests, Saver and Damasio conclude that in the absence of emotional input, EVR's decision making process was overwhelmed by trivial information. With additional studies, the researchers conclude that EVR had no internal goal representation. In order for goals to remain stable for EVR, they had to be represented externally and repeatedly. Otherwise, '...it was as if he forgot to remember short- and intermediate- term goals.... He couldn't keep a problem in perspective in relation to other goals.'"
Damasio's hypothesis, widely accepted today, is that there is a strong connection between emotional processes and intellectual processes: our emotions are equal partners, if you will, in our intellectual lives. This is especially true in practical decision making. Domasio theorizes that "somatic markers" are the mechanism by which emotions conspire with thought to produce decisions. Essentially, every goal, every means to that goal, every intermediate step and all possible alternatives along the way are encoded with emotional attributes of which we are not consciously aware. As Barnes and Thagard write:
"The somatic marker hypothesis is presented by Damasio to explain these experimental findings. The hypothesis is that bodily feelings normally accompany our representations of the anticipated outcomes of options. In other words, feelings mark response options to real or simulated decisions. Somatic markers serve as an automatic device to speed one to select biologically advantageous options. Those options that are left unmarked are omitted in the decision-making process. Damasio suggests that patients with frontal lobe damage fail to activate these somatic markers which are directly linked to punishment and reward, and originate in previously experienced social situations. EVR's decision making defect is explained by an inability to activate somatic states when ordinary decisions arise; by an inability to mark the implications of a social situation with a signal that would separate good and bad options. EVR was therefore trapped in a never-ending cost-benefit analysis of numerous and conflicting options. In the absence of emotional markers, decision making is virtually impossible....
"Damasio claims that un-marked options are not considered by the decision maker. This biasing function of somatic markers is really what makes decision making possible. In the absence of markers, the decision maker has too much information to deal with. The computations involved are so cumbersome that they cannot yield a final decision. In short, emotions dictate and constrain which bits of information are used."
To oversimplify a bit: our minds make decisions much the way Deep Blue makes chess moves. The brain spins at incredible speed through, and discards, thousands and thousands of alternative paths before percolating one or more up into the conscious mind for final action. For each, it makes a complex calculation based on the somatic markers; it uses them to weight the relative acceptability of each option. People with reduced affect -- flattened emotional life -- simply cannot read the somatic code and find themselves paralyzed by simple decision making tasks. They manifest, in short, exactly the sort of behaviors that Efron describes in Clinton: a preoccupation with details as a substitute for the decision making.
(If this sounds fanciful, remember that brain damage or dysfunction has revealed many wondrous and unsuspected things about human consciousness. For example, there is the famous case of the man -- an accomplished college professor -- who, because a brain lesion, mistook his wife for his hat.)
Let me try to explain, with an analogy, why a simple inability to read somatic markers produces the bewilderment of Cleckley's indecisive diner and Efron's indecisive president. OS/2, the computer operating system I prefer, allows files to have "extended attributes" of up to 64 kilobytes of data. Let us say that we design an application that can sort out desired files rapidly by narrowing the search according to data stored in these extended attributes. Now we move that application and all the files to a machine running DOS, which has no facilities for recognizing or storing extended attributes. Without the data previously found in those extended attributes, the application will thrash around without effect.
There is a close resemblance between psychopathic traits and the symptoms attendant upon brain trauma of the sort just described. Some researchers actually argue that psychopathy is the result of either trauma to or arrested development of the prefrontal cortex and the limbic system. One theory is that the psychopathic brain is organized differently (resembling the consequences of physical trauma) as the result of imperfect socialization in the very early years -- arising either from inherited deficits or from a pathological family environment (or both). Whether this is true or not, both psychopathy and such brain trauma are functions of a similar, profound emotional deficit, both apparently arise in the same brain structures and both manifest remarkably similar symptoms.
If there is a subtle difference in the descriptions of indecisiveness in psychopaths and of brain trauma victims, it is because psychopaths tend to be studied in prison settings and brain trauma patients in hospitals. But all these studies indicate that pure reason is unimpaired in both. The subjects can pass tests designed to identify intellectual impairment. But all these tests are theoretical. If the element of practical, personal decision making is added to these tests the subjects fail -- flailing about helplessly. This is equally true of both psychopaths and trauma patients. One of the latter, for example, after hours and hours of questions designed to test his ability to solve theoretical ethical problems -- tests which he passed with normal scores -- commented to the clinician, "You know, after all this, I still would not know what to do."
The emotionally crippled psychopath does not know, in situations calling for decision, how to think. In the unsuccessful psychopath this results in a ruined life. In the successful psychopath, it results in a career of constant crisis -- and the ruination of the lives of others.
Earlier, I referred to Clinton as an "adaptive psychopath." In part, this merely means a successful psychopath, one who has avoided jail or asylum. A psychopath more able to function in the real world whether, as Rieber says, because of "superior endowment or because their survival was facilitated by adopting an outwardly [normal] facade." But Rieber means something more subtle by "adaptive psychopath." And this can only be understood in terms of his description of the underlying psychopathy -- not that he disagrees with Hare and Cleckley. He has a slightly different emphasis, which arises from studying "Psychopathy in Everyday Life," the subtitle of his book, instead of psychopathy in prison populations.
"In my view," he writes,
"the following four salient characteristics -- thrill seeking, pathological glibness, antisocial pursuit of power, and absence of guilt -- distinguish the true psychopath."
This is more than merely impulsive behavior. Often considerable planning is involved, as well as the cooperation of accomplices. This behavior may be due, in part, to a higher threshold of "perceptual stimulation" among psychopaths, leading to thrill-seeking, drug use and violence (sexual or otherwise).
Also psychopathic thrill-seeking is qualitatively different from normal boredom defeating pursuits.
"Psychopathic thrill-seeking consists in breaking the rules, whatever they might be, or even in surreptitiously making up new rules. At a poker table, psychopaths do not want to win; they want to cheat and get away with it. That is, they want to turn the game into a new game, where they make the rules."
Adaptive psychopaths, he says:
"have taken this to a paradoxical extreme: They can go about their routine duties precisely because they have turned them into a dangerous game of charades, of passing for normal, while in their off-hours they live an entirely different life."
Clinton manifests this in all aspects of his life; from his golf Mulligans to his interpretation of the ten commandments. Some psychopaths also manifest fearlessness -- even seek out physical danger. Clinton. a physical coward (remember the expression of testy panic when the crowd broke through the barricade in Africa?), does not share this aspect, perhaps the result of the swollen ego trying to "maintain viability." But his entire adult life, lived under a microscope, has been one long game.
"Pathological Glibness: The Manipulation of Meaning in the Communication of Deceit"
All psychopaths, at every level of intelligence, are remarkably glib and persuasive. Cleckley also talks about "semantic dementia," by which he means that the psychopath is unmoved by the ordinary emotional demands of a situation and act as if they do not exist. Rieber takes this further:
"[T]he same dissociation is also manifest in their speech; words have become detached from meaning and serve instead as a means of placating a dangerous foe or of fleecing an unwary victim. By the same token, they do not allow themselves to be moved by words and concepts that their fellow citizens value."
If there is one trait of Clinton's that stands out, even against the backdrop of hairsplitting lawyers, politicians and consultants, it is his use of language. His grand jury testimony is a case study in semantic dementia and verbal dissociation. A careful look at moments such as the lesson on the meaning of "is" reveals a tiny flash of triumph on Clinton's face. He has cheated in plain sight and won.
"Antisocial Pursuit of Power"
Psychopaths are preoccupied with power relationships. Not only are they interested
"in obtaining maximum power for themselves, but they seem hell-bent on using power for destructive ends. Only in paranoid states and in the attitudes of career criminals can a comparable fusion of antisocial trends with the power drive be seen. It is as though, for psychopaths, power can be experienced only in the context of victimization: if they are to be strong, someone else must pay. There is no such thing, in the psychopathic universe, as the merely weak; whoever is weak is also a sucker, that is, someone who demands to be exploited."
This also typifies Clinton's approach to the use of power -- over women, over opponents and even over allies. To highlight but one instance: look at Clinton's justification for exploiting his lawyer's gullibility in believing his own client, Clinton, himself. It also underlies Clinton's dealings with Congress -- both majority and minority -- and his ongoing shell games with policy.
Psychopaths, it has been noted, tend to invade the space of others to intimidate or dominate. Often this takes the form of a piercing, unwavering gaze. Women sometimes interpret this as seduction, as Monica Lewinsky reports about herself. Men also feel it, although in different ways. Bob Woodward mentioned on Larry King recently that this is what he first noticed about Clinton during a face to face meeting. Even a glass of diet Coke never occluded that unblinking laserlike stare.
"Absence of Guilt"
Psychopaths are not ignorant of law and its sanctions. They simply ignore the former and seek to evade the latter. They are, therefore,
"skilled in evasion and rationalization. Some, gifted histrionically, can even feign remorse. But they do not feel guilt.... [W]hen psychopaths are caught they are in a profound sense uncomprehending."
If one thing marked Clinton's great apology tour, following discovery of the soiled dress, it was total and absolute insincerity. Where are the religious counselors now that he has escaped removal? If you read all the statements of regret and the comments about mutual forgiveness, only one conclusion is possible: Clinton is, on the one hand, presenting a facade of guilty shame to evade repercussions while, simultaneously, taking pleasure in manipulating the words so as to never say what his "sucker" audience thinks he is saying.
The sum of these parts is what Rieber refers to as the "Mephisto Syndrome."
"[I]t is hard to resist the impression that the true psychopath is a personification of the demonic.... They are not social, only superficially gregarious; not considerate, just polite; not self-respecting, only vain; not loyal, only servile and down deep they are really quite shallow.... Hence the observed homologies with the figures of the demonic: ...For the psychopath, the demonic is a way of life....
"[S]ince like the devil psychopaths are inherently asocial, they are difficult to comprehend within the confines of ordinary human morality. [T]he true psychopath, like Lucifer, goes beyond the categories of evil and sin; theologically, the true psychopath is incapable of forming any relationship to God or to humans.... Not feeling remorse, psychopaths enter the confessional, as they enter psychotherapy, only when it serves some other purpose, typically that of evading punishment....
"[T]he power of the group is real; if properly organized the group can accomplish things well beyond the power of any individual. The individuals, for their part, participate in the exercise of group power through identification....
"Psychopaths, by contrast, appear to situate themselves altogether differently vis-a-vis the group. Rather than adopt a posture of identification, they appear to... proceed on the delusionary belief that in their own person they can emulate and create the degree of power that, properly speaking, only the group has. More than a law unto themselves, psychopaths act as if they were a whole nation unto themselves.... [reminding us of de Gaulle's famous saying that nations have no friends, only interests.]
"Dissociation is a critical cognitive process in psychotherapy. It is manifest in the pathological glibness, in the inability to feel guilt, in the inability to profit from experience, and in the semantic dementia, generally, of the psychopath.... [D]issociation refers to the tendency of individuals to... dissociate... their 'real' selves from their 'public' selves. Such people histrionically alter their public presentations to create a succession of socially acceptable images or facades....
"With psychopaths, dissociation reaches to a deeper level; paradoxically it is also more readily put to the service of the pathologically inflated ego. Where the histrionic splits off the 'bad me' from the 'good me,' ...the psychopath's internal split seems seems to take place at an even more basic level, that of the 'me' and the 'not me....' [T]here is nothing that is 'not me' for psychopaths. There is no limit to the grandiosity of their fantasies, likewise there is no limit to what they might do....
"[The psychopath's] deeper dissociation is utterly uncontrolled, and this makes it practically impossible for psychopaths to do anything else but con at the level of social valuations.... [T]he same is true of the kind of rationalizations and trumped-up emotions psychopaths rely on.... [T]here is a level of conscious ego-involvement in these techniques, but it is a pathologically inflated ego..., an ego that has lost the ability to produce either genuine reasons or genuine feelings...."
I have been asked by readers of early drafts of this manuscript, whether there is some sort of inherent, instinctive defense that some people have against the awful, mesmerizing charm of the psychopath -- an instinct such as the one that causes people to "fear snakes and spiders, for instance." I, too, have suspected as much. Both my wife and I manifest what I jokingly call "CRS": Clinton Repulsion (or Revulsion) Syndrome. We noticed it one evening when our hands collided reaching for the remote to mute the television. It first manifested itself long before Clinton was a frontrunner and long before we began discovering his pathological personal life. Since then, I have seen ample evidence that we are not alone. In fact, I would suggest that some significant minority of the American population feels (literally feels, on a visceral level) as we do. About an equal number, apparently, are fully under his spell and would enter the fires of Hell for him.
I have written Robert Hare, the foremost living researcher into psychopathy, about my ideas about the way people react to psychopaths. (Not specifically about Clinton but using some notorious examples from the literature.) He seems to agree that my insights have value and ought to be explored.
At the core of the "Sun King," William Jefferson Clinton we see hidden in plain sight this intractable pathology, this emptiness and its horrible power. Psychopathy in the world's most powerful leader creates a terrible dilemma for a democracy. The psychopath is not mentally ill or mentally impaired as these terms are meant in the law or the 25th Amendment to the Constitution. But he is, as noted by all the experts, just as dangerous as if he were, perhaps more so. Just as unfit for high office, perhaps more so. Psychopaths do not just blunder blindly into evil; they seek it out. Can the Vice President and the Cabinet remove the elected leader of the nation on the basis of "moral dementia"? Do we really want to re-enact the Caine Mutiny on a national level? Any move to remove this clearly unfit creature from office must, it seems to me, come from the Congress. This route, however, has now all but been foreclosed.
A chorus of soft voices has arisen calling for "counseling" for this man who sits at the pinnacle of power -- allegedly suffering merely from some popular form of addiction. This is arrant nonsense. There is no pill, no treatment, no therapy and no exorcism that can "cure" him or those like him. These creatures are profoundly alien. Visitors from a parallel moral universe. They can never interact with ours as anything but soulless predators.
Unfortunately, I believe that I have also made my case that the policy chaos and paralysis that Efron described in Clinton and his administration are -- along with his grandiosity, dishonesty, recklessness, unreliability, sexual predation -- symptoms of a profound emotional deficit arising from either true psychopathy or some youthful trauma to his prefrontal cortex. Someday, perhaps, his medical records will solve the mystery. In the meantime, we are governed by an adaptive, charismatic psychopath, a supreme intraspecies predator, armed with mesmerizing powers of seduction -- even mass seduction. A leader with profound emotional, cognitive and moral deficits that paralyze his reason and interfere with the simplest decisions -- and endanger this Nation.
And there is virtually nothing we can do about it.