Jim Pittaway: Is there more to John McCain's rage than just bad temper? A psychotherapist puts the candidate on the couch.

Roundup: Media's Take

[Jim Pittaway is a licensed psychotherapist. He resides and practices in Missoula, Mont.]

He has been called McNasty and Senator Hothead, but John McCain has called his fellow senators far worse. Newsweek reported that he "erupted out of the blue" at Budget Committee Chairman Pete Domenici, saying, "only an a--hole would put together a budget like this." He called Sen. Chuck Grassley a "f---ing jerk" and capped a profane tirade during last year's amnesty debate by screaming "f--- you" at Sen. John Cornyn. Then there was the scuffle on the Senate floor with Strom Thurmond when the South Carolina senator was a less-than-spry 93.

No one is immune from his outbursts. A pair of Arizona physicians, Robin Silver and Bob Witzeman, went to meet McCain to discuss their concerns about a telescope project he wanted to fund. "He jumped up and down, screaming obscenities at us for at least 10 minutes," Silver told CounterPunch's Jeffrey St. Clair. "He shook his fists as if he was going to slug us."...

As we explore explanations for some of Senator McCain's actions, it is important to bear in mind that any professional who would render a definitive diagnosis on an individual he has not interviewed or tested is prostituting his credentials. But when someone places his life in the hands of voters, it is reasonable to examine behaviors in light of diagnostic criteria. It must be understood that my explanations cannot possibly be certain. That said, I believe it is highly likely that John McCain suffers from Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). The question I face as a citizen, and would invite readers to weigh, is one of probability and the degree of risk associated with the level of probability.

One of the great difficulties encountered by many TBI patients is the invisibility of the organic damage and the subtlety of the effects of even moderate brain injury. Indeed, many clinicians who work with TBI have come to view brain damage as a continuum we all fall on—it's just a matter of the relative extent of damage and severity of the symptoms. In our program, we treat many men and women who are high-functioning individuals, but seem just a bit "off." Their peers have to "walk on eggshells" so they don't "set them off" or "get them going." But moderate TBI is not necessarily a barrier to material success or political power.

There are three signal characteristics of moderate TBI: emotional disregulation (volatility), perseveration (inability to let go of thoughts and feelings or see them in broader perspective), and concrete thinking (abstractions and nuance are compressed into right or wrong, good or evil, people are either "for me or against me"). The difference between these attributes as personality characteristics or organically driven compulsions is subtle. How far do they deviate from appropriate behaviors, and are they moderated or exacerbated by time and the aging process? Where is the all-important line between emotional control and disregulation?

Obviously, there are batteries of sophisticated tests, and even diagnostic imaging that can rule TBI in or out, but John McCain has made it clear he will not only not co-operate, he will not abide discussion of anything of this nature. In the absence of his willingness to deal with such matters, we are forced to rely on his public record.

It speaks clearly: John McCain possesses, even trumpets, these characteristics. In addition, his biography records protracted episodes of violent abuse of intensity sufficient to make it all but impossible for him to have escaped without organic—and psychological—damage to his brain. It is sad that any such damage would have been incurred in honorable service to his country, but what is at stake is far too important for these possibilities to be ignored....
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