Bush on the Couch

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Dr. Frank is the author of Bush on the Couch: Inside the Mind of the President (2004). He is a Washington, D.C.–based psychoanalyst and professor of psychiatry at George Washington University Medical School.

Book by Justin Frank If one of my patients frequently said one thing and did another, I would want to know why. If I found that he often used words that hid their true meaning, and affected a persona that obscured the nature of his actions, I would grow more concerned. If he presented an inflexible worldview characterized by an oversimplified distinction between right and wrong, good and evil, allies and enemies, I would question his ability to grasp reality. And if his actions revealed an unacknowledged – even sadistic – indifference to human suffering, wrapped in pious claims of compassion, I would worry about the safety of the people whose lives he touched.

For the last three years, I have observed with increasing alarm the inconsistencies and denials of such an individual. But he is not one of my patients. He is our President. He wants to remain our President for four more years, and he intends to do so on his own terms. On August 27, the eve of the Republican Convention, Bush said to New York Times reporters Sanger and Bumiller that “he would resist going ‘on the couch’ to rethink decisions.”

Since the Swift Boat controversy hit center stage in mid-August – both the ads and Bush’s refusal to take responsibility for them – we again see his reluctance to examine his conscience. Instead he remains mired in his long-standing pattern of denial and blame. Responsibility is something this president flees at all costs. It is a behavior pattern that began long before Bush became president, governor, or even a college student. It even began before Bush had become an alcoholic (he finally stopped drinking at age forty, with the help of his religion), though his response to criticism is typical of untreated alcoholics.

Bush was the first born child to a family that had long and moneyed traditions on both sides. When he was three and a half his sister Robin was born. It has been said that the nursery rhyme “Humpty Dumpty” was written with the first-born child in mind. It seems to capture perfectly the irrevocable trauma felt with the second child is born: Nothing can put the first-born back together again. Of course, first-born offspring find different ways to manage this insult. Some can be suspicious and overly competitive; others can be overtly nice while covertly furious; still others always keep an eye on the second child, making sure he doesn’t get too much. First-born children keep careful track of how much food mother gives to their siblings.

But if the second-born dies, as Robin did when George was seven, then an entirely new and complex dynamic is set in motion. The first-born often has to disown his destructive fantasies and banish them into his unconscious. But such fantasies threaten his mental equilibrium and he has to do something with them. One solution is to project them outward, thereby experiencing people around him as destructive or a source of danger.

By the time Robin died Bush already had a mother who was emotionally elsewhere. Children resent it when the mother is absent, and Bush’s resentment would have grown stronger in the face of his mother’s grief after Robin’s death. If George’s feelings were never addressed – and it is clear from numerous family accounts that the parents didn’t have a funeral and never talked to George about the loss – his natural animosity toward his sister would have remained unresolved; he would have been left with a host of forbidden feelings that were too threatening to acknowledge, only furthering the process of having to disavow these unwanted aspects of himself. He was deprived of the opportunity to learn to mourn, to heal. In that deprivation lays the kernel of what has by now become Bush’s knee-jerk reaction of denying responsibility for anything that goes wrong. He can’t allow it to be his fault.

It is true that blame and denial are arguably as typical of politicians as of alcoholics, though the latter are generally more likely to involve family members in the process. But blame is also a reminder of one’s destructive impulse; the individual who hasn’t resolved his anxieties surrounding that impulse is particularly motivated to avoid confronting those anxieties, which he can accomplish by shifting responsibility to someone else, or denying it outright. Drinkers turn to alcohol to suppress anxiety.

The untreated alcoholic who has simply stopped drinking treats anxiety as an enemy, and with good reason: He is often more challenged by anxiety because he has lost his time-tested means of numbing its sting. He knows that anxiety is a threat to his abstinence – he fears anything that might lead him back to the bottle – but his years of drinking get in the way of learning other methods to manage uncomfortable feelings. Bush manages his anxiety through his inflexible daily routines – the famously short meetings, sacrosanct exercise schedule, daily Bible readings, and limited office hours. All public appearances are controlled and staged – even the ones that appear to be spontaneous. They have to be.

But when routines fail, denial kicks in as the treatment of choice to manage the potential development of internal chaos. The habit of placing blame and denying responsibility is so prevalent in George W. Bush’s personal history that it is apparently triggered by even the mildest threat; when Jay Leno, on the eve of Bush’s DUI revelation (just a week before the 2000 election), asked him if he’d ever done anything he was ashamed of, he replied, “I didn’t” – and proceeded to tell a humiliating story of his brother Marvin urinating in the family steam iron. Fast forward to the Swift Boat ads, taking a brief stop at his denial that he knew Ken Lay (“Kenny who?”) of Enron who was in fact a friend and major contributor to his campaigns; then to his blaming 9-11 for the failing economy when the market actually began to crash after he announced his tax cut plans; then to his inability to admit to any mistake he made after 9-11 (in the April 2004 press conference he couldn’t bring himself to accept even a modicum of responsibility for either the intelligence failures before 9-11 or for the war in Iraq), to his denial in May of knowing Iraqi information source Chalabi despite having invited him to sit just behind the First Lady at his 2004 State of the Union Address. Putting it all together, we see a pattern that I call the KWD – the Kenny Who Defense. He employs it whenever and wherever he can, whenever he feels threatened.

All his disavowed destructiveness coalesces and requires management whenever anybody challenges him. He becomes instantly wary: Questions mobilize his anxiety and invite that exaggerated degree of rigidity he uses for self-protection. It is not a matter of intelligence per se, but a matter of paralysis when confronted with any question that requires thinking. When there is nobody in particular to blame he stumbles anyway, as he did at the Unity Conference on August 6 when asked to discuss the sovereignty of the Native American tribes. Mark Trahant, of the Seattle Post-Intelligencer, noted that children study city, county, state and federal government but that Indian government is not part of that structure. In noting Bush’s unique experience as governor and president, he asked about Bush’s understanding of sovereignty and how to think about tribal conflicts in the twenty-first century. Bush hesitated, and then said, “Sovereignty means [pause] that you’re a sovereign – that you’ve been given sovereignty and can be viewed as a sovereign entity. Therefore the relationship between Government and tribes is one between sovereign entities.”

His relationship to his father makes all the more sense in light of the anxieties I have described. First, his father cast a giant shadow: he was a good student, a fine athlete, a war hero, a successful businessman. One grows up in awe of such a father – and given this particular son’s need already to disown his own feelings of destructiveness, he imbues his father – partly by projecting his own aggression onto the father – as a man of enormous power, making him more of a threat. And young George W. had few of his father’s qualities with which to defend himself. Being a cheerleader and a big fraternity drinker are just not the same thing. This situation can make a son feel rage, frustration, and shame.

One way Bush managed his feelings was through his humor, his sarcasm (not unlike his mother), and his need to be in charge of any undertaking. At times, being in charge meant mocking his father’s power (being stick-ball commissioner while his father had been an All-American first baseman is a good example). One particular power that George Sr. did not express, however, was the important paternal responsibility to help a son separate from his mother. I doubt the success of that endeavor with George Jr., as his father was absent for most of Bush’s childhood. And when he was present, George Sr. was absently reading or distant.

This particular son is driven by the need to retaliate – against his father and against a world full of enemies. He does so in a variety of ways – though the underlying motives are the same. He tells Bob Woodward that he needn’t consult his father before invading Iraq because he consults a stronger higher father; he regularly introduces Vice President Cheney as the greatest vice president in history, without mentioning that his father was VP for eight years; he dismantles international coalitions once valued by his father; he practices what his father called “voodoo economics” by implementing massive tax cuts for the rich, maintaining that deficit spending will revive the economy; and at the Republican Convention in New York, he doesn’t make a place for his own father – an actual ex-president – to speak. Each event taken on its face value is but an incident. When they are linked together they reveal a distinct pattern.

His drive to manage anxiety is paramount. That requires him to shift responsibility whenever possible. He can consciously deny blaming his father for having failed him in his time of greatest need as a child – in helping him both stand up to his mother and to let go of his need to be her cheerleader rescuing her from her unspoken grief. But unconsciously, the blame persists – crippling his ability to think. He remains a cheerleader, not a leader. The inability to take responsibility makes Bush genuinely unable to lead: he can bully others and seem to act decisively, but he retreats from threatened confrontation (he says “bring em on” only when embedded behind the Secret Service thousands of miles away from the battle). His need to remain in control makes him unable to think things through in order to lead from strength. His is a stage-managed strength, something we saw all too clearly during the week of the Republican Convention.

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Andrew W Gage - 9/17/2006

I have to wonder if any of you (mostly) gentlemen actually read the book before posting to this thread, or if you’re just coughing up partisan opinions. Because the way I see it, if you’re flailing criticisms about the book and its author and jousting at each other with quips and insults - without the benefit of actually having read the material - then you are certainly no less guilty of drawing armchair conclusions than Dr. Frank is of his applied psychoanalysis of the president.

I read the book and found it interesting… a little dramatic and definitely partisan, however the doctor makes many valid points throughout and it should be enough to plant seeds of doubt and concern not only about this administration, but where it is taking us in the 21st Century.

Doug D Lawrence - 4/19/2006

This silver spoon fed, disfunctional man wouldn't even gain notice if he weren't our president, we've had rather inept presidents in the past from both parties, but we've never had one that scares the hell out of me like this one, this man is obliviously unstable at best & should be sanctioned eeerr I mean baby sat.

Avram Jacob Mirsky - 9/4/2005

Spare us what? The truth? That we have a pathological wounded child in the White House who is leading this nation into darkness? Or is this the new reality?

Nora Freeman - 1/8/2005

Not only is it not a violation of psychiatry's professional ethics, it is an entire subdiscipline of psychiatry known as applied psychiatry. Its primary practitioner is, surprise surprise, the CIA. And in any case, it couldn't possibly be a violation of professional ethics as there is no relationship between them and therefore no way that anything in his book could damage W., either financially or psychically. Anyway, as Dr. Frank points out, as a public figure from a well-known family, much of W.'s life is already known to him, offsetting the disadvantage that he has never met the president.

Stephen Thomas - 10/29/2004

Mr. Chamberlain.

You might want to consider this: The voters agree with Mr. Bush and they disagree with you.

You might want to think about that.

Oscar Chamberlain - 9/20/2004

Particularly in biography, a close cousin of history, there is a well-established tradition of using psychological concepts to analyze subjects. However, it does have its perils, some of which you point out.

So to answer your question, analyzing historical figures, living and dead, does have a place at HNN, but such attempts should be analyzed with care.

Lance Michael Gritters - 9/18/2004

Someone explain to me how this is the appropriate forum for some psychoanalyst to try and give some "professional" (meaning absolutely not biased in any way) analysis of the President? Has he even met the President? Talked with him? Oh wait, he does not agree with the President, so the President must be "sadistic". There is probably a good reason he is not peddling this in a psychiatric journal...there is nothing scientific or objective about his analysis. So again, why is this on the HISTORY News Network?

Lance Michael Gritters - 9/18/2004

Someone explain to me how this is the appropriate forum for some psychoanalyst to try and give some "professional" (meaning absolutely not biased in any way) analysis of the President? Has he even met the President? Talked with him? Oh wait, he does not agree with the President, so the President must be "sadistic". There is probably a good reason he is not peddling this in a psychiatric journal...there is nothing scientific or objective about his analysis. So again, why is this on the HISTORY News Network?

stephen Brody - 9/17/2004

Chris, Chris, so much invective, so little reasoning. I feel really short changed by your unimaginative and trite insults. I’ve been the recipient of far more effective insults from people with far less education than you. I was hoping for better.

1. “By the way, my uncle is head of psychology at University of West Virginia Morgantown, and I do have a bit of a background on the topic,…”

Hell, Chris, why didn’t you tell us this earlier? Having an uncle as a psychologist certainly qualifies you as an expert in psychology. But tell me this; is your self-described title as a “human rights scholar” similarly based upon the second-hand expertise of a relative? Was your aunt actually the human rights attorney? Have a cousin who actually belongs to the IALANA? I guess by this measure, if your nephew were a surgeon, you’d be a medical expert.

Is there any subject that you’re not qualified to provide expert testimony about?

I guess your multiple references to me as “a nut” must be based upon your expert credentials as the nephew of a psychologist.

2. “I should apologise for the brusqueness of the original response”

Why start apologizing now, Chris? Even a casual look at your posts shows that your usual tactic is to answer disagreement with invective. I have come to accept you as you are-- someone who is really not comfortable dealing in facts and logic.

I mean, I came to realize long ago that if there weren’t at least a few gratuitous insults in a post, it wasn’t the real chris pettit doing the posting.

3. “the discourse on this site should be intelligent and well thought out,”

Who among us could read your latest post and doubt your sincerity about this?

Chris, you’ve become a caricature of the pompous, know-it –all poster, who claims real and imagined expertise about every possible subject. Ease up a little and try to remember that nobody takes you NEARLY as seriously as you apparently take yourself.

Ben H. Severance - 9/17/2004


Generally speaking, I define a pacifist as one who opposes all war unconditionally, in an abstract sense, but who can conditionally tolerate and participate in war that is either in defense of a homeland under direct attack or is promoting a genuinely humanitarian cause, such as intervening in one of those many African starvation crises. Admittedly, a humanitarian cause invariably runs afoul of other foreign policy interests.

It is with this definitional constuct in mind that I labelled you a pacifist. And given you extensive involvement in humanitarian causes and learned arguments about internationalism, I think the descriptive is apt. Besides, I regard pacifists as honorable and brave people; it's easy (and sometimes cowardly) to be a jingoistic war-monger.

Years ago, I was surprised when a fellow army lieutenant informed me that he was pacifist. I asked why he volunteered for the military, and he responded that it was his civic duty to "provide for the common defense," but that if America every embarked on what he considered an unjust war, then he would become a conscientious objector. I lost contact with him shortly thereafter, so I have no idea what stance he took during Desert Storm (let along the current debacle in Iraq). Anyway, bravery comes in many forms. My "spiderman" comment was actually meant as a compliment. Your blogging has a "superhero" quality to it.

Oscar Chamberlain - 9/16/2004

Mr. Thomas.

I'm sure many voters do agree with Bush. However, it is one thing to have the positions that people may like; it is another to communicate them.

As an example. Many people argued that Clinton's past as a child of an alcoholic was one source of his ability to communicate empathy. If so, that gave an emotional component to some of his policies, and that was one source of the support that many conservatives found so mystifying.

I'm simply suggesting that, if this analysis of Bush has any merit, a similar phenomena may be helping him.

chris l pettit - 9/16/2004

Out of the shadows? Hardly. I simply get too busy with my lecturing and human rights work here in Africa to be able to engage in (usually) insightful conversation and debate with such knowledgeable scholars as Ben and Oscar (good to see you again) and refute some of the ignorance (Buddhist definition) and silliness that comes from people such as Mr. Brody and a few other nuts who post on the website.

By the way Mr. Brody, you will note that I never agreed nor supported the article above. I actually find Dr. Frank to be a bit off in his appraisals, especially since he has never sat down with the President and does not know him from anything other than the media sources available. I do not know whether the doc reads international press, where one can actually find some decent analysis that is lacking in the great majority of the US media (I would say 95% +). I was simply commenting on your post regarding him being a nut. The pot calling the kettle black in every aspect of the phrase. By the way, my uncle is head of psychology at University of West Virginia Morgantown, and I do have a bit of a background on the topic, so I can assert that some of the claims made by the doc are credible in his analysis, but can be discredited by the fact that he does not have all the facts, nor access to the everyday workings of the President's mind and personality. Insofar as his assessment goes...one can take it with a grain of salt and note the errors as they exist. but as far as I know, the man still has his right to speak his mind and have his views heard, no matter how spurious they are. As I said before, if nuts were censored, Mr. Brody, you would have been silenced long ago. My plea for you to retreat from whence you came is simply a request that would enable those of us who can actually contribute intelligently to this website to have better discussions without having to deal with the simplistic and narrowminded extremist elements among us.

Now...the pacifism question...I guess we would have to define our terms. I absolutely contest any assertion of any sort of "just war" theory that supposedly arises from any religious or ethical tradition. That being said, I do not think that I could be termed a pacifist because I do accept and support the Article 51 self defense exception (within the accepted legal definition of self defense...a missle is on the way and there is absolutely no time for rational thought on the matter) articulated in the UN Charter and also the right to use forceful means (whether that mean military action or not) as long as it is explicitly allowed and regulated by the United Nations and the UN Charter and does not violate universalised international legal norms. Anything having to do with Iraq, for example, falls well outside any of these standards. So I would not consider myself a pacifist in the traditional sense, but I guess it depends on ones definition. Ben, I would suspect that you might term me a pacifist, and might look at what I would call a pacifist as maybe an extreme or absolutist pacifist? I am not sure, you will have to define the term for me. It does make for an interesting discussion!

I should apologise for the brusqueness of the original response. I was only indicating that nuts like Mr. Brody responding to nuts (and as I indicated above, I will be the first to question the errors in Dr. Frank's position and the paucity in advancing what could be a spiteful political argument...unfortunately we do not know whether Dr. Frank is sincere, but flawed in his analysis, or whether he is trying to make a biased and vindictive political statement, which would hurt the reputation of psychology as a discipline) like Dr. Frank was rather silly, given our 1st Amendment right to speak our minds...and that if Dr. Frank is to be censored by HNN or any other periodical, Mr. Brody surely should be censored as well.

Even though it is often caustic, the discourse on this site should be intelligent and well thought out, something that Mr. Brody seems incapable of achieving (along with several others I could point out)...hence my request, which he has every right to refuse. He can also request that I remove myself from the board because my articulate comments to the other fantastic scholars who post and write for HNN are simply above his field of comprehension. I might refuse, but he can certainly ask.

Ben...I take the jest in good heart...and it is good to chat with you my friend! You too Oscar! By the way...I am sure neither of you meant anything too harsh...and pokes at my short jabs that appear once in a while in response to ridiculous statements made by certain people are certainly appreciated. it also helps to get me to acknowledge that sometimes those short posts are better left unsaid (though not in this case).

Mr. Brody...if you want evidence of my trash talking skills, you should join one of the fantasy football leagues I am involved in. Granted I have not busted out the language on DC yet over in the Rebunk league, but I would certainly not waste my breath on idealogues such as yourself. I was simply making a quick point and reference to your ignorance (Buddhist definition) of the world around you outside of your own farcical fantasy.

Cheers everyone!


Oscar Chamberlain - 9/15/2004


Granted I wasn't trying to be funny but, to revert to the language of my youth, I didn't mean the comment to be as "heavy" as it seems to have come out.

Val Jobson - 9/15/2004

You need a smilie emoticon. :)

Ben H. Severance - 9/15/2004

I am hoping that Chris takes my tongue-in-cheek jest with a lightheartedness that you evidently do not display. But such are the limitations of blogging where facial expressions and voice inflections can never be conveyed.

stephen Brody - 9/15/2004

Jesus, Chris, is that the best you can do in the insult department? I really expected something more interesting and subtle from a man of your claimed education. Not very impressive for a “Human Rights Scholar”.
What is this, some new dialectic you’re trying out down at the International Association of Lawyers Against Nuclear Arms?

Of course, Chris, I DO understand your affinity for the good Doctor. While he normally answers every challenge to his facile analysis with “but I’m a Doctor”, your usual defense is “But I’m a Scholar”

Not very persuasive coming from the Doctor. Even less so coming from you.

Oscar Chamberlain - 9/15/2004

There is no inherent reason that a pacifist in action need not be wrathful. It's probably easier mentally to have emotion and logic (or dogma or faith) in union--Jesus, Buddha, and a whole lot of better people that I have said so--but most of us mortals schlog on in our own wavering, inconstant ways, trying to make our actions, at least, halfway good by our lights.

Besides Chris, are you a pacifist?

Ben H. Severance - 9/15/2004

From out of the shadows, he strikes again! Beware the wrath of a pacifist.

chris l pettit - 9/15/2004

you would have been gone long ago...

why don't you return to the hole from which you crawled?


stephen Brody - 9/15/2004

For God’s sake, would somebody please get some tin foil and make this guy a helmet.

If anyone needs some couch time it’s this publicity hound. He turns up every so often, on talk shows and the like, spouting his unsupported and unsupportable claptrap. Whenever challenged, he invariably bleats “but I’m a Doctor”.

HNN, give us a break.

Ken Melvin - 9/14/2004

No degree needed here folks. Many of us knew from the first we layed eyes on him. The goofy walk, snicker and that damn chainsaw are but further confirmation. On NOW 9/10, Bush is shown mit chainsaw in hand while some five men position the prop, i.e., the log, in a dance where none know the basic steps.

John H. Lederer - 9/13/2004

" Since the Swift Boat controversy hit center stage in mid-August – both the ads and Bush’s refusal to take responsibility for them – we again see his reluctance to examine his conscience. Instead he remains mired in his long-standing pattern of denial and blame."

Of course, he might not be responsible for the Swift Vets.

Hans Vought - 9/13/2004

Ugh! This pathetic attempt at psychohistory is almost as bad as Sigmund Freud's hatchet job on Woodrow Wilson. Surely it is a violation of psychiatry's professonal ethics to attempt to psychoanalyze someone whom one has never met. If not, it should be.

Is there any hope that this election could include discussion of issues and ideas, rather than blind hatred and paranoid rumors?

Oscar Chamberlain - 9/13/2004

There may be some truth in this analysis. If so, it may also give a glimpse into Bush's strength with the voters. That "stage-mamaged strength" provides a sense of direction. And in the absence of a coherent campaign showing what's wrong with that direction and why another would be better, many voters are going to prefer that.