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Libel in Fact Magazine: The Challenge to the American Psychiatric Association

A secret of psychiatric diagnosis in the 1960s is revealed

Up until the 1960s, the American Psychiatric Association provided little explicit guidance for how a psychiatrist might speak to the media about the mental health of a politician or other person in the public eye. Such ethical issues certainly were discussed among psychiatrists: Sigmund Freud, for example, believed that such public analyses ought be carried out only of historical figures -- that is, the deceased. Although many psychiatrists limited their comments on public figures as a matter of personal conscience, others likely felt that the public had a right to know their opinion of a public figure's mental status. That would all change as a consequence of the 1964 US presidential election.

As the 1964 election season drew to a close, then-President Lyndon B. Johnson and his opponent, Senator Barry Goldwater, continued a polarizing and often frightening public conversation about war -- including nuclear war -- peace, and the future of the United States. Inserted into that debate were key questions about character -- in particular, what level of mental stability would be desirable for a leader who could order nuclear strikes around the globe. It was in that context that Fact Magazine had polled psychiatrists across the country as to Senator Goldwater's mental health. When Senator Goldwater sued the magazine for libel, he potentially dampened such important discussions.

The Fact magazine poll and the legal battles that ensued not only changed libel law in the United States (see here), but also the way that psychiatrists could responsibly speak about public figures.

Fact's publisher, Ralph Ginzburg was brilliant at marketing. In advance of his special election issue containing the poll results, he took out one hundred thousand dollars worth of advertisements promoting Fact magazine, and indicating that Senator Goldwater's character would be brought into question. These advertisements appeared in the New York Times and other major media outlets.

The anticipation of the 1964 election-issue of Fact magazine grew in many quarters during the weeks before its publication.

Some members of the psychiatric community were especially concerned about what the issue might contain. The executives of the American Psychiatric Association had been alerted by their membership that Fact would contain a poll of psychiatrists' opinions as to Mr. Goldwater's state of mind.

Dr. Daniel Blain was president of the American Psychiatric Association at the time. A former Christian missionary, he had turned his attention to spreading the gospel of psychiatry around the world. The Association's medical director at the time was Walter E. Barton.

Hearing of the poll, Dr. Blain and Dr. Barton wasted little time in composing a letter to Fact that condemned the results in advance of its release. In their letter to Fact (never published in that magazine, but shared with The New York Times), the two physicians accused Fact of publishing "a hodgepodge" of personal, political and professional opinions, and engaging in "yellow journalism." They continued:

"By attaching the stigma of extreme political partisanship to the psychiatric profession as a whole in the heated climate of the current political campaign, Fact has in effect administered a low blow to all who would advance the treatment and care of the mentally ill of America."

Drs. Blain and Barton were correct that political partisanship could well taint psychiatry. There was another equally salient issue, however, that was likely to arise for those who had read Fact's poll. Although this issue went unstated in the letter from the two physicians, it may well have weighed upon their minds.

This issue was the revelation of how much disagreement there was among the psychiatrists' assessments of Goldwater. In the poll some psychiatrists viewed Senator Goldwater as normal, some viewed him as grandiose, some saw him as obsessive, some as paranoid, and still others as paranoid schizophrenic. These disagreements raised the issue of whether the psychiatrists might have similar issues in agreeing on a diagnosis of the patients under their care -- a genuine problem which was only beginning to be grasped in the 1960s.

The low blow wielded by Fact magazine, in other words, was to reveal an embarrassing reality -- one only beginning to be recognized by psychiatrists themselves -- that they did not agree very much in their professional opinions (see here, also). The survey further suggested that many of the psychiatrists were a fairly critical bunch when it came to perceiving the character of those around them.

One of the cardinal rules of measurement (of which personality assessment and psychiatric diagnoses are special cases) is that measures (the psychiatric opinions, in this instance) must agree to a reasonable extent. Without that agreement, there can be no confidence about what is being measured.

The knock-out punch by Fact -- revealing the disagreement -- was inadvertent. It was analogous to the wild punch thrown by an amateur who defeats the pro by doing the absolutely unexpected.

Perhaps the readers of Fact gave the psychiatrists a pass even in the face of their disagreement, knowing that none of the physicians had interviewed the Senator professionally.

Either way, the leadership of the American Psychiatric Association was aggrieved. Not only had a number of its members willingly applied their expertise to a controversial political discourse, but in doing so, they had revealed their lack of agreement -- at least in viewing a person from afar.

The Association, and the medical establishment more generally, would try to prevent future embarrassments in the public realm with a new ethical standard that became known as "The Goldwater Rule," which I will describe in my next post.

Notes

Most of the material in this post is based on earlier posts in this series. The reaction of the American Psychiatric Association to the Fact article was reported in: Anonymous (1964, October 2nd). Doctors deplore Goldwater poll. New York Times, p. 20.

Freud's opposition to psychoanalyzing living public figures is expressed in the Introduction (p. xiv) to Freud, S., & Bullitt, W. C. (1967). Thomas Woodrow Wilson: A psychological study. Boston: Houghton Mifflin. Freud's sentiment is discussed also on pp. 178-180 in Elms (1976). Personality in politics. New York: Harcourt Brace Jovanovich.

The "...readers of Fact..." paragraph and a slight rewrite of the following paragrah was added +20 hours after posting.

Copyright © 2010 by John D. Mayer

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