The United States presidential race of 1964, although only a passing footnote in the annals of history, quietly marked a major watershed moment, not in politics, but in the field of psychiatry.
It was a race between the Democratic contender Lyndon B Johnson and the Republican candidate Barry Goldwater.
The saga between the two demonstrated that history truly has an odd sense of humour. Because, even though Barry Goldwater's political career played out without much fanfare, his name became etched into the books of the American Psychiatric Association (APA) forever.
Barry Goldwater was the ultra right-wing, ultra conservative, Republican party candidate that year. His campaign was so conservative, that it was considered too far right in the political spectrum even by some of his own party members.
In other words, Goldwater was a hard-liner. As such, he was a divisive figure, as was his presidential campaign. It was in this environment of tension that the editors of Fact Magazine, decided to conduct a poll by asking 12,356 psychiatrists the following question:
"Do you believe Barry Goldwater is psychologically fit to serve as President of the United States?"
The response to this poll set off a wave of different reactions and heated debate in the American culturesphere. While the political response was predictably delineated along party lines, the psychiatric community was divergent on the issue.
Many answered the survey question point blank saying that based on Goldwater's public statements and speeches, he can be characterized as "suffering from chronic psychosis", "megalomaniacal", "paranoid schizophrenic" and "[having] the same pathological makeup as Hitler, Castro, Stalin".
However, others within the psychiatric community found this type of survey objectionable to begin with.
For example, Dr. Thomas Stach MD, who said "it was astounding to me when the survey first came out. It was impossible for a psychiatrist to come to a conclusion like that without a personal examination. The psychiatrists who were baited into giving responses were imprudent."
Many believed that those who characterized Goldwater as unfit for office, were playing out their political biases in their psychiatric opinion. And so, as they saw it, it was fundamentally unethical.
Debate and discussion ensued for many years it seemed, until finally in 1973, the APA made a formal response by the adoption of Section 7.3 in its code of ethics, which came to be known as the Goldwater Rule.
The rule sets boundaries of ethical behaviour by psychiatric professionals, specifically with regards to public figures, and states that "[I]t is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement".
The Goldwater Rule set in motion psychiatry's quiet retreat from the political arena. In general, the APA felt that their professional practitioners had no business getting involved in the political realm.
And it remained so for decades after, until very recently, with the election of Donald Trump, discussions about the rule have resurfaced in the field.
As of today, as many as 60,000 American psychiatrists have characterized him as being mentally unfit for office. In repeated violations of the Goldwater Rule, these psychiatrists have signed numerous letters, petitions and written books, making public their professional opinions on the psychological fitness of the sitting President of the United States.
Take a moment, as you fully grasp the Orwellian absurdity of it all. Your political stance aside, just seeing it as a governance issue, makes for quite a chilling scenario.
The importance of psychological fitness for being in a position of power, might seem like an obvious imperative on the face of it. But as we play politics in the world today, there are no set of guidelines, principles or systems checks, to ensure that the leaders that we are electing into power are psychologically balanced.
It would seem that as a society we have failed to learn from history of WWII, when a single psychologically imbalanced individual in a position of power, essentially hypnotized an entire populace, bringing unimaginable cruelty and inhumanity upon the world.
Although a repeat of such an episode in the age of nuclear weapons would be exponentially more disastrous, we continue to act like we have learned nothing from these historical episodes, from the phenomenon of Hitler or Stalin or Pol Pot.
Any country stands to be at risk if those who hold the seat of power are psychologically imbalanced and have demonstrably poor judgement.
Moreover, as long as our vision of democracy remains as sophisticated as a high school popularity contest, the throne of leadership and power will intrinsically attract individuals with larger than average egos, and a naturally inflated sense of self.
While we politely call this "ambition", the truth can often be much darker than that.
Although most of us might instinctively agree with the adage that "the best leaders are those who do not want to lead", our current system categorically has no place for such individuals.
It is by definition the domain of "ambitious" personalities, large egos with more than latent narcissistic tendencies. While there is a thin line between these traits and pathology, it seems that nobody is keeping an eye on that line. Lost in the fanfare, the need to do so is all but forgotten.
The unfortunate truth is that a leader who embodies pathological narcissism is likely to do very well in an election, as their forceful and rigid stance on positions is more appealing to a vast majority of the world population today.
This not only speaks to the state of our leaders, but is also a commentary on the psychological state of most people in the world.
Jerrold M. Post in a paper titled Narcissism and the Charismatic Leader-Follower Relationship, early childhood trauma can leave a person with the "need to attach himself to a powerful, caring other." Post claims that for such individuals, "it is extremely attractive to ……….. repose one's faith in the leadership of someone who conveys his conviction and certainty that he has the answers, that he knows the way."
In truth, no childhood is free from some level of trauma. The best parenting efforts cannot completely wipe all damaging childhood experiences for anyone.
As such, we are all susceptible to the seduction of narcissistic leaders to some degree. But certainly, some of us are more damaged and susceptible than others.
These psychological realities have played into the rise of the "Right Wing Bros Club" today. These "bros" include the likes of Modi, Trump, Duterte, Bolsonaro, as well as Kim Jong Un, Vladimir Putin, Mohammad Bin Salman.
These leaders thrive on populist politics and display more than average levels of narcissistic tendencies.
Unsurprisingly, looking at any meetings between them, it is obvious that these men adore each other. As they look deeply into each other's eyes they see themselves, mutually recognizing each others' "ambitions", their shared narcissism.
This is why, the rise of the Right Wing Bros Club and the politics of hysteria they practice, uncomfortably reminds some observers of 1930s Europe.
The global left, "liberal" class, that had foolishly assumed that reasoned arguments and a clean moral record would be important determinants of becoming a leader, are shocked by the right wing populism spreading across the world.
Their rise to power thrives on fear, "us versus them" rhetoric, dualistic viewpoints and a blind self-righteousness. Meanwhile, their supporters see their simple speech and complete disregard for facts, as a statement against the often arrogant intellectualism that arises from the left.
Most of all, what they all seek and find in these leaders is the sense of conviction and certainty, which they have longed for all their lives.
It is important to note that all of these dynamics are fueled by deep rooted primal psychological factors, both within the leaders and amongst the broad voter base.
The expression of support has nothing to do with policy or truth, but has everything to do with emotions. While we can admit that democracy is the best system we have, we must also admit that it can only accommodate leaders that crave power. While for some this craving does not necessarily become narcissistic, for others it certainly can.
As such, the response from the psychiatric community to the election of Donald Trump, rightly recognizes these concerns. And so, the following questions must be asked.
Should psychiatry be allowed to wash its hands of this issue? Should it not be playing a societal role, as unbiased evaluator, to ensure that the egoic self-expression of our leaders are not dangerously pathological?
Or is it that we are afraid of what we will find if we were to look within the minds of our leaders? Could we end up realizing that none of them are fit for power?
If so, would that not be a good place to start envisioning a new system, to choose leaders from among those whose primary drive is not power? While these may seem like distant issues, these questions will determine the difference between our existence and extinction in the near future.