What is that phrase ‘clinically significant’ doing in the American Psychiatric Association’s definition? It’s there to show that a disorder is the sort of thing that causes people to ask for help and that then moves doctors to offer it. That requirement makes sense—we want disorders to be severe at a level deemed worthy of attention—but it also makes the whole system of psychiatric diagnosis less useful. A condition is a disorder if we agree that it is. And there’s something unsatisfying in that sort of criterion: If two people react to challenges in the same defensive way, but one person happens to succeed in life and the other to fail, can it be that one is medically impaired and the other not?
Perhaps that conundrum of psychiatry should be the subject of a separate, longer discussion; for now, the purported diagnosis serves mainly to put an insult to Palin in a fancy wrapper. If I were like you, I’d seek treatment, may be the underlying sentiment. Or simply: You should.
Palin may duck the narcissism rap on another basis as well. The APA criteria for personality disorder also refer to “experience and behavior deviating markedly from the expectations of the individual’s culture.” On her home turf, Palin fits in fine. Citizens of her hometown Wasilla get her. As Purdum writes, “In the same way that Lyndon Johnson could only have come from Texas, or Bill Clinton from Arkansas, Palin and all that she is could only have come from Wasilla.” And also, “Sarah Palin herself is a microcosm of Alaska.” If you come from a society in which backbiting and dogmatism are apparently acceptable political behaviors, then those acts or postures cannot contribute to a psychiatric diagnosis.
On a more serious note, it strikes me that what may be at play in the pop psychologizing about Palin is class prejudice. New York Times columnist Ross Douthat makes this point; Palin suffers from not having gone to Columbia College or Harvard Law School and, very likely, not having wanted to.
[I'll try to avoid politics in general on this blog – but this is a thoughtful take on the silliness of pathologizing our enemies. -Ed.]
Douglas Faneuil is the founder of Living Proof Productions, a not-for-profit devoted to suicide prevention based in New York City. He also designs database solutions for companies throughout the Northeast.