"Can the President Think?"…Continued

Readers respond to REASON's November cover story, and author Edith Efron responds to the readers.


If one flies high over the reader mail, both "Talk Back to REASON" postcards (mostly unsigned) and signed letters, one sees three broad and emotionally intense reactions. Readers were either passionately appreciative or vehemently bored or violently antagonistic. Here is the overview:

The Friendlies

From the postcards: "fascinating," "compelling," "VERY interesting!!!," "intelligent and edifying," "a most astounding piece," "superb article…A+ writing," "fantastic," "fantastic," "outstanding," "outstanding," "excellent," "brilliant," "splendid," "riveting…fascinating…superb," "should be mandatory reading for all citizens."

From the letters: "I…thank REASON for Edith Efron's fine article," (Roy Hofschneider, Upland, CA); "superb article," (Manuel S. Klausner, Los Angeles, CA); "Thank you, thank you, thank you, for Edith Efron's article on Bill Clinton's mind," (Elizabeth Desilets, Malden, MA); "Edith Efron's fascinating and frightening analysis of Bill Clinton's 'cognitive disability' helps us to understand [him]. If he has an exaggerated need to please, is especially sensitive to criticism, has grandiose notions, has poor powers of introspection and is unable to hang on to the meaning of abstractions, we can better understand [his puzzling statements and behavior]," (Joan Mitchell Blumenthal, New York, NY); "Thanks so much for Edith Efron's study on the mental processes of Bill Clinton. Fascinating, and most instructive….It seems her article and Nathaniel Branden's Six Pillars of Self Esteem [reviewed in the same issue] are linked. Here we have a president who lacks a number of the necessary 'pillars' of self-esteem: cognitive confidence, accurate perception of self and reality, and such a need for other people's presence to validate his own existence that he cannot bear being alone with himself for even a few moments….He seems to obtain his self-hood from others (Peter Keating?), hungers for power over others (Ellsworth Toohey?) and cannot bear to learn the truth about who he is (James Taggart?). He concentrates on the pain of others to block out his own internal and personal pain (Philip Rearden?). He's a sad case, all right. Perhaps we should send him a copy of Branden's book, and set up a 31-day program for him? Nah…the last thing we want is an efficacious Clinton before November elections! Let's go to the polls and really make the man feel pain, by throwing every Clintonite out of office! Then we send him the book!" (Diane Joy Baker, Cincinnati, OH); "I appreciate Ms. Efron's effort in the presentation at removing the 'political issues' from any contention. It is my opinion she has largely succeeded. She has brought about a change in my feelings for Mr. Clinton; where once I detested him for what he was, approaching hate, I now have a tinge of sorrow for the man. Were he not in the position he is in, I would have a great deal of sympathy for him." (Harry J. Herder Jr., Hayward, WI)

The Bored

From the postcards: "It would have been 10 times better if it had been condensed into 2-3 pages," "It was good but it was too long," "too long and repetitious," "a bit long," "too repetitive," "much too long," "much too much precious space wasted; it could have been dealt with in a 4-5 page article," "way too long," "too long, not persuasive," "far too long, goes without saying."

From the letters: "I really think Efron is grasping at straws. While she did not say that our Prez was certifiably bonkers, she came close. I am sure if you judged former President Reagan under the same scrutiny (or Bush, even), you could piece together a case for ineptitude. On top of that, it was just plain dry reading. If I want to be barraged with such rhetoric, I can do my homework. I was bored halfway through." (Paul R. Hawley, Loma Linda, CA); "Whatever led you to devote 24 precious pages to Edith Efron's tedious and repetitively detailed psychological analysis of Bill Clinton's mind? She may have a point: Bill probably is nuts. But why take so much space to 'prove' it? I don't read REASON for its ironclad psychiatric diagnoses. It's political analysis I look for when I open each issue. For just a brief whiff of that, I had to slog through to the very last page of this vicious, issue-hogging article." (Shirlee A. Hoffman, Chicago, IL)

The Hostiles

From the postcards: "You print more garbage like this, I will cancel my subscription," "unenlightening psychobabble and just plain stupid," "S.I. Hayakawa is rolling in his grave at her unethical use of language," "one-sided…not fair to Clinton."

From the letters: "I just can't believe that you devoted 25 pages to the namecalling and mudslinging in November 1994's issue on Clinton. It was so mean-spirited that it spoke volumes about the author's mental state—and I was disappointed beyond words that the REASON editors chose to publish an article of such length from such a source." (Mary Fayer, Richland, WA); "Twenty-eight pages of Clinton bashing in the last issue is like eight hours of Rush Limbaugh….Sorry, after over 15 years as a subscriber, I can't take it any more. Please cancel my subscription and refund the remainder." (Harold Trautman, Portland, OR); "Please cancel my subscription immediately. REASON magazine, which I eagerly awaited for well over a decade, no longer exists. Your 24-page piece on Bill Clinton's mind is the most repugnant piece of 'journalism' since Barry Goldwater was psychoanalyzed in 1964….I must conclude that REASON wants to emulate the explosive circulation growth of rags like American Spectator. Tabloid journalism—the frenzied exploitation of fears and prejudices—is overwhelming American culture. So while I'm sure the gutter will bring you more readers, I will not be one of them." (Michael J. Hihn, CompuServe 76360,2063); "What were you all thinking when you published Edith Efron's article (dissertation)?…The stuff of Ms. Efron's article…is the conjecture-laden, paranoid, whiney, half-informed/half made-up drivel I can get from Rush Limbaugh every day for three hours (but choose not to)….Ms. Efron's article is so far from your mission of "Free Minds and Free Markets," and so much lower in research quality, and so petty in its tone, that if this is the editorial direction REASON is taking, I no longer wish to receive your magazine." (John Larkin, Washington, D.C.)

Ms. Efron comments: It is unnecessary to say that if I am to be pelted with adjectives, I prefer those of the appreciative writers. I thank Joan Mitchell Blumenthal for her clear summary of Clinton's traits—in particular, for her recognition that his inability to connect abstractions and concretes is essential to understanding his incompetence. Diane Baker's analysis of my article via the works of Ayn Rand was amusing. I note that she needs four Ayn Rand villains to describe one Clinton. If she works at it, she can get it up to six. Harry Herder's shift in feelings from a detestation of Clinton, verging on hatred, to pity touches me. I very much wanted readers to feel that way.

All writers inspire boredom in some readers. One cannot thrill everyone. But these Bored are not like any other bored I've ever seen. These do not just yawn and sensibly take up with a writer more to their taste. These want to make a federal case out of their boredom. If there were an EEOC for the Bored, they would sue me. This is unusual. Can one answer the Bored? No, one can't. They are the mirror opposites of the people who find my writing compelling, riveting, and fascinating. Those people always report that they couldn't put my writing down. The Bored are the folks who cannot pick it up.

By now, I presume you are getting the idea. The article on Clinton was compelling, riveting, fascinating, brilliant, superbly written, sensitive. It was tedious, repetitious, too long, too long, too long. It was repugnant, ill-written, slimy, mean-spirited, tabloid, Rush Limbaugh, American Spectator, cancel my subscription, cancel my subscription.

There is, of course, no need to answer abusive letters. But these have one important use. Certain themes come up repeatedly and, by implication at least, certain questions are repeatedly asked. What follow are letters—some abusive, some merely critical, a few supportive—that address issues which appear to concern many of the writers.

General Criticisms

Edith Efron offers some convincing explanations as to why she considers Bill Clinton odd. Unfortunately, in doing so she loses track of the really interesting question, namely why so many people considered him so normal for so long. As an early and well-battered critic of Clinton's I was repeatedly reminded that whatever characteristics he possessed were not his alone, but resonated comfortably throughout the city's establishment.

What might be considered rational behavior by Efron or myself is regarded as archaic stodginess by postmodernists such as Clinton. In fact, to a true postmodernist, for whom words are merely tools of transient symbolic utility, the whole idea of a magazine called REASON is absurd. Again, Clinton is unfortunately not odd, but only an extreme product of the situational values, unremitting hubris, and manipulative skills taught by the nation's law and management schools in the 1980s. I have run into Clintonesque types who are university presidents, ministers, museum directors, and even farmers. I have, I confess, come to believe that you shouldn't trust anyone within a five-year standard deviation of Bill Clinton's age.

In describing Bill Clinton as crazy, we let our political and social culture off the hook. I think it more important to face up to the really sad truth that once again our electoral system gave us what we wanted. The good news is that we seem to have discovered our mistake and that the failings of the Clinton administration may have finally killed that excrementitious decade whose only service to the world was the invention of the minivan.

Sam Smith
The Progressive Review
Author, Shadows of Hope
Washington, D.C.

As a libertarian subscriber to REASON, I have many reasons to lament Clinton's presidency, even to enjoy reading an accurate account of the clinical causes of its decline. But as a subscriber to REASON because I am enlightened by its analysis of policy, I was disappointed that you chose to sacrifice 48 columns (!) and cover status to an article that had nothing to do with policy.

Only in the last column of her article does Efron begin to touch upon questions which would have been interesting for us to explore more fully—namely, is there a systemic fault in our electoral process which permits, possibly even promotes, the election of idiots into higher office?

Boris Starosta
Charlottesville, VA

I was very disappointed by the fact that this magazine published a 24-page article purporting to present a psychological profile of Bill Clinton. As an economist I find such a topic inherently uninteresting. As a matter of fact, it makes very little difference to those suffering the adverse effects of Clinton's policies how those policies came to be formulated.

But more importantly, this article perpetuates the current media myth that the presidency is a powerful political institution in the formulation of domestic policy. Modern presidents have found themselves hampered by congressional budgetary powers and by the fact that their constituency includes many powerful interests on both sides of important policy debates. This latter fact often leads to paralysis in the executive branch. Congress, in contrast, deals with such special-interest conflicts on a piecemeal basis. The fact that Congress extended the committee system in the early 1970s by allowing subcommittees to proliferate is evidence of its desire to improve its dealings with special interests. If libertarians are interested in reducing the political power of those in Washington, they need to stop focusing on Bill Clinton (tempting target though he may be) and start thinking about a radical reform of the way Congress does business.

George S. Berger
Economics Department
University of Pittsburgh-Johnstown
Johnstown, PA

Ms. Efron comments: I quoted Sam Smith twice in my article—on the subject of Clinton's dependence on others to give him a sense of his own reality, as well as on the subject of the shallowness of Clinton's commitment to his own professed values. So acute an observer of Clinton is Smith that I had to be forcibly restrained from quoting several yards more of his book, about half of which is a brilliant and marvelously well-written study of Clinton as an exemplar of irrational "postmodern" trends. Smith summarizes those trends in his letter as "the situational values, unremitting hubris, and manipulative skills taught by the nation's law and management schools in the 1980s," which he describes as an "excrementitious decade."

Smith despises the cultural counterrevolution of the '80s the way elderly ex-leftist neoconservatives despise the cultural revolution of the '60s. If one thinks in terms of decades, Smith and I should be natural enemies. But we are not, and for a very good reason: I share Smith's horror at the assault on words, on definitions; at the systematic destruction of language as a way of identifying objective reality. I share his revulsion at the mockery of the very notion of objective reality, of the need for a rational epistemology, of the need for logic.

According to Smith, the postmodernist inhabits a fluid universe where A can be non-A at will; where there is no past and there is no future, only the need of the moment; where there is no truth and there are no lies. This is the universe inhabited by Clinton, he says, and the really interesting question is "why so many people considered him so normal for so long."

There is, however, a significant difference between Smith and me, and it may or may not be bridgeable: Smith sees Clinton, the two Clintons, and the Clintonites as stamped out by an external cookie cutter called "the postmodernist culture." He therefore investigated the external culture. I investigated Clinton's internal psychology, a psychology formed decades before the cultural developments Smith laments.

Smith thinks we have to choose between an externalist and internalist explanation and that "in describing Bill Clinton as crazy, we let our political and social culture off the hook." (I expressly said Clinton is not "crazy.") I say Smith is letting Clinton's individual mind off the hook. But we do not, in fact, have to choose.

Boris Starosta was deeply disappointed that my article deprived him of a portion of the policy fix he relies on REASON to provide every month. And George Berger simply states that he finds the subject of the president's psychology "inherently uninteresting," spelling out the institutional issues he thinks REASON should be writing about. Together, they think my article is almost entirely irrelevant to policy.

That depends on how one defines policy. Both Starosta and Berger, and others like them who felt deprived of the roster of policy analyses characteristic of REASON, are defining policy in the tradition of the social sciences, where only institutions and groups of people are worthy of discussion. They have been taught to look down at anyone who takes individuals, "personalities," seriously. But there are crucially important fields which focus on individuals, such as painting, sculpture, literature, history, biography, and certain journalistic forms, such as the profile, which traces its lineage back to fiction and biography. And the profile as used in modern American journalism is a potent political weapon.

Finally, I must say that it is particularly weird to find myself trying to convince individualists that individuals are worth thinking about. For whose sake are they so desperately concerned with policy? For pigeons?


What a wonderfully perceptive piece in this month's REASON. Thank you for going easy on my youthful tendencies to purpleness. I am more embarrassed by the writing than the sentiment.

Philip Martin
Staff writer

Arkansas Democrat-Gazette
Little Rock, AR

Since none of the writers are the president's psychiatrist, any conclusions reached are obviously subjective and only useful to defame the person.

Robert A. Turk
Rockwell, TX

To Ms. Efron's credit, she has obviously read extensively the published accounts of Mr. Clinton's life and times, but these sources are at best second-hand, and most likely third-hand. This reliance on second- and third-hand sources of information greatly diminishes the credibility of Ms. Efron's article and her conclusions.

I did not find the article totally, blatantly offensive because, as Ms. Efron notes, Bill Clinton is a public figure of no small significance. The article did have many interesting insights, which, if they are true, could serve to explain Bill Clinton's psyche. Unfortunately, these insights rest on shaky foundations, those second- and third-hand sources. Because Ms. Efron has no personal knowledge of Bill Clinton (even if she has met him, I seriously doubt whether she is his confidant in any way, shape, or form), her information regarding Mr. Clinton's mental processes comes solely from other people who may or may not have axes to grind against Bill Clinton, may be lying, or may simply be faulty judges of such matters. Ms. Efron's conclusions, tightly reasoned and well documented as they are, are merely speculations on the inner workings of Mr. Clinton's mind.

Jason Smith

Ms. Efron comments: My thanks to Philip Martin, the Arkansas journalist whom I quoted in the article as the writer of a youthful hymn to Clinton's glory, describing him as the Sun King. I'm particularly pleased to have someone who has covered most of Bill Clinton's political life find my article "wonderfully perceptive."

Martin's note, however, would have no meaning to Robert Turk, since Martin is not Clinton's psychiatrist. According to Turk, any conclusions Martin may have reached "are obviously subjective and only useful to defame." Nor would it assist Jason Smith, who is determined to settle only for first-hand sources. It is not just Martin whom Smith would judge in this fashion. It could be Meg Greenfield, editorial page editor of The Washington Post, or it could be the Post's David Broder, dean of America's political journalists, or it could be Maureen Dowd of The New York Times, or Joe Klein of Newsweek. Smith is appalled by the very notion of settling for second-hand, let alone third-hand, sources and a number of other REASON readers were similarly outraged. I could understand why they might balk at trusting conservative and libertarian journalists, on the ground of bias against a liberal president, but I am disturbed by the inability of such readers to recognize that the overwhelming majority of the journalists I quote in my article are liberals and that this means that my sources were biased in favor of the president, not against him.

I was totally unprepared, given REASON's demographics, to find highly educated people—academics, professionals, and business executives—who have no idea how to evaluate my sources. I yield to no one in my reverence for first-hand sources. In my last book, on environmental cancer and carcinogenesis, I had about 1,500 references, all first-hand sources, which fattened the book by another 100 pages. But there is something bizarre about this passion for first-hand sources in dedicated readers of a magazine which does not publish footnotes. And their demand for first-hand sources for information about a president of the United States is far more bizarre, because it tells me these particular readers do not have the faintest idea how political journalism works or how citizens acquire their information about the inhabitants of the White House.

In my article, sources were, with a few Arkansas exceptions, among the most authoritative political journalists in the United States. The list could be expanded, but those whom I cited are luminaries of the American press. They write for the national newspapers, for the national newsweeklies, and for nationally read political and opinion journals. Some appear frequently on network TV, on CNN, on C-SPAN, on CNBC. Among the politically literate, the people I quoted are household names. And they should be, because such stellar journalists are among the most powerful and influential interpreters of the American political scene. To put it plainly, they tell the political classes what to think. I haven't the faintest idea whether those who expressed their craving for first-hand sources actually want to know how to assess my sources. But for those who do, I offer some information and advice.

The information is this: Despite the overpowering illusion of intimacy created by television, citizens do not and cannot know very much about an American president. There is a chronic and overwhelming shortage of first-hand sources of information. An American president plays a symbolic role in our society and may not make a blithering fool of himself in public if anyone can prevent it. Thus, almost nothing that the reporter or the citizen sees is spontaneous. All public speech is rehearsed. Even gestures are rehearsed. P.R. techniques are used as a barricade against the prying eyes of the press and the citizens.

Even when a private interview with the president is granted, and a journalist is allowed to pass the public barricade, the reporter immediately hits a private barricade. Questions must be submitted in advance, and only a fool would submit provocative questions. The situation produces self-censorship. The interview itself is monitored by an aide or press secretary, who will terminate a line of questioning curtly if a forbidden subject is broached. What is forbidden? Everything that might conceivably embarrass the president, which in Clinton's case is almost everything.

There are exceptions to this rule, of course—quid pro quo arrangements offering the president advantageous coverage in exchange for exclusivity. But for the most part, an interview with the president is primarily useful to the working journalist because it permits him to say, "I was at the White House and the president told me…," which causes people to think they are hearing the inside dope.

That is not usually how journalists get the inside dope. They get it by talking about the president with others—which is to say, from second-and third-hand sources. By the time a citizen hears it, the information is fourth-hand. And this is to describe the best and most meticulously done presidential journalism in the United States.

Herewith an example of the sources of one of the journalists I quote—Elizabeth Drew. It is an author's note in her book on the Clinton presidency, On the Edge, which was published after my article appeared: "This book is based on regular interviews with every high official in the Clinton White House on the broad range of issues, foreign and domestic, that the President confronted—or was confronted with. My interviewing also involved frequent sessions with cabinet officers involved in these issues, and others in the various agencies, as well as members of Congress and Capitol Hill staff members whose angle of vision and expertise could shed light on the Clinton presidency. Not-so-famous White House aides were also tremendously helpful in clarifying issues and helping me understand events."

But that, some REASON readers would say, is just a lot of unsubstantiated gossip. Wrong. That is how gossip is substantiated. That is how it is confirmed. Apart from direct quotes from Clinton, what you see in my article, is confirmed observation. I quote journalists, including Drew, who devote their days, and often their nights, to constant interviews and confirming missions. If I quote five stellar journalists saying that the president cannot organize the toys in the bathtub, I am relying on at least 10 other sources—two confirmers per journalist. If it's a hot or controversial observation of Clinton, I am relying on at least 15—three confirmers per journalist. Behind every journalist's observation of Clinton's behavior in my article lies the sort of reporting Drew describes.

So much for information. What about advice? Here it is: If you want to test what I have written, READ. Pick two national newspapers, two national newsweeklies, three political journals in addition to REASON, and read all books published on the president or his wife. Keep all my major points about Clinton in mind, and track the material on those points to see if writers are confirming or refuting them.

Start with Elizabeth Drew's book. She is one of the most careful journalists in America and politically sympathetic to Clinton. And if you've read reviews of the book, you have just gotten the barest hint of the degree to which the information it contains about Clinton's personal characteristics validates my article.


I am saddened that one of my favorite magazines has been infected by the psychobabble that is characteristic of so much contemporary journalism. Moreover, Edith Efron is just exactly wrong about Clinton. The problem with President Clinton is not his indecisiveness but that his judgment is so bad when he does make a decision. Most of the critics of Clinton's indecisiveness are from the left; they want Clinton to make more decisions of the type they prefer. Does REASON really want Clinton to make more such decisions? Clinton merits praise or criticism for what he says and what he does, not on the basis of some wholly untestable speculations about his mental processes. Moreover, to this reader, such pop psychology is morally offensive.

William A. Niskanen
The Cato Institute
Washington, DC

Ms. Efron comments: If William Niskanen wants to establish that I am "exactly wrong" about Clinton's indecisiveness, he will have to refute my sources. He will have to demonstrate that the following journalists are "exactly wrong" on the question of Clinton's indecisiveness: Eleanor Clift, Mark Miller, Bob Woodward, Cokie Roberts, Elizabeth Drew, Anthony Lewis, Hobart Rowan, Judy Woodruff, E.J. Dionne, David Shaw, Jeffrey Klein, Paul Greenberg, Bob Cohn, Al Hunt, Michael Kelly, Mary McCrory, Ann Devroy, and Ruth Marcus. Unlike Robert Turk and Jason Smith, Niskanen is indifferent to the truth or falsity of the statements by the journalists I have quoted. He is interested only in motivation and strategy: True or not, if "the left" is motivated to say something, REASON should not say it.

Niskanen ought to brush up on the historical sciences, where speculation abounds and theories are impossible to test because they pertain to unique events that occurred billions, or hundreds of millions, of years in the past: cosmology, much of astronomy, geology, evolutionary biology, biological anthropology. Niskanen's definition of science is defective.

He could, however, test his own psychological theory, to wit: "If REASON calls attention to a trait of Clinton's psychology, Clinton will promptly reverse that trait." Nice, short, elegant, easy. Do it.


Although I agree with much of Ms. Efron's article, I must raise two objections, one ethical and one intellectual.

Libertarians should have learned a lesson from the presidential campaign of '64, when Barry Goldwater was unfairly slandered as a paranoid by several high-profile psychiatrists. Since that time it has been considered unethical for psychiatrists to engage in speculation on a public figure's psychiatric diagnosis. The fact that Edith Efron is not a mental health professional makes her use of diagnostic classification even more disturbing, since she is not trained and experienced in the field and is basing her assumptions purely on collateral data and not clinical examination.

The second objection is that one cannot impugn a pseudo-intellectual by using a pseudo-intellectual manual. Thomas Szasz has written extensively about the silliness of DSM-3R ("Diatribe of Sophist Musings," in my opinion), which once considered homosexuality a mental disorder and now considers a whole host of problems of everyday living forms of mental illness.

Bill Clinton should be judged upon his history and his behavior. He is a megalomaniacal, insecure, distractable, habitual liar from a broken home. In essence, he is a brighter version of his brother (and thus a poster child for Charles Murray's "cognitive elite"). A psychoanalysis based upon second-hand sources is neither necessary nor appropriate.

James O'Brien, M.D.
Los Angeles, CA

I am incensed with Edith Efron's vicious personal attack masquerading as psychoanalysis. A president's personality—his "character"—should be at issue. If he has a mental illness that may affect his performance, that should be too, as long as the discussion is informed and rational. This piece fits neither characterization. It is character assassination with a thin veneer of psychology intended to lend it legitimacy. It is telling that this piece was not written by a psychiatrist or psychotherapist but by a "journalist and author." Since when are journalists experts in DSM-3R diagnoses, let alone their interpretation? From a distance? Clearly, qualified professionals should do the diagnosing here.

Efron's piece is an attempt to label Bill Clinton, not examine his mental competence. And she throws almost every diagnosis in the book at him trying to find something that will stick in the reader's mind.

John Cronan
Hatfield, PA

President Clinton has no shortage of political inadequacies. It is also perfectly legitimate to question presidential style and motives in his handling of political issues, in addition to, of course, his decisions. Claiming he is mentally ill and engaging in psychiatric name-calling, however, such as "obsessive compulsive personality disorder" and "attention-deficit hyperactivity disorder"—oops, sorry: Efron says it's only significant that ADHD sufferers think Clinton is a fellow sufferer—only communicates that conservatives cannot challenge Clinton on the issues. Conservatives—and REASON—can do better, much better.

Using psychiatric labels to discredit a president is the last rhetorical refuge of a political scoundrel and holds the strong potential for winning (deserved) sympathy for the victim. With enemies like Efron, the president will need fewer friends.

Richard E. Vatz
Associate Psychology Editor

USA Today Magazine
Towson, MD

Your feature article in the November issue, "Can the President Think?" was more than superb. The author, Edith Efron, expresses more insight than I think even she is aware and did a truly magnificent job. I hesitate to say it was self-revealing for me, since this brings the image of a weeping confessional to the fore, which is definitely not my intent. Rather, I would mainly like to thank both the magazine and the author.

That being said, I offer the following in the hope that it will aid in the comprehension of what must seem a totally incomprehensible mindset. I think that by briefly exploring from the inside, relating how such a mind ticks, I can open a window clarifying the view.

In my mind, which I believe was as your article describes, there was a most definite cognitive impairment, although I did not realize it. Seeing all sides of an issue can be beneficial, but imagine trying to deal with everything your brain ever learned about a subject all at once, and then add in every other subject that may have a connection, and everything related to those subjects. The part of the brain which is supposed to impose control and order on all of these neurological impulses is not working. Seizing just one idea is almost impossible. Staying with that one idea is daunting. Getting lost in the jungle is common and the confusion can be terrifying.

There does seem to be some relief in learning new information. Whatever is last entered into the brain tends to remain a short while on top, masking the lack of order. Therefore the thirst for information is neverending. The problem with this escape is in the way that it works; by avoiding the deeper chaos, one also avoids all that is basis for an original decision, idea, or thought. The cycle is self-perpetuating; the more that is learned, the more internal competition.

In a sense more practical to your article, this means that if one viewpoint is learned, it has definite prominence. If contradictory information is then learned, it has precedence. Listening to many advisers is almost suicidal, amounting to saying yes to everyone in the room. There are few if any filters to qualify any views acquired, and treachery is easy to implant, as is the thought that prior advice was treacherous.

The marvel is not chaos, but the appearance of any results! Competent at analysis after the fact, it's very visible that something is very wrong, but the ego won't let go. The resultant mantra: I try too hard to do too much, reflects yes, of course, I'm smart enough to know something's wrong, but it's only because I'm so much better and work so much harder than everyone else that I get into trouble. Do you want me to slow down and stop working miracles for you? Normal others are incapable of seeing all that's being done and need constant explanations, poor sots. One so impaired fails to see how anyone else ever gets anything done with so little apparent effort, and decides they must not be accomplishing anything of quality.

Michael P. Masora
Rockledge, FL

Ms. Efron comments: I'm pleased that Dr. O'Brien agreed with "much" of my article and would have liked to know what that "much" consists of. I regret that he did not read the article with care before leaping to his typewriter. I said repeatedly that I was basing my investigation on diagnostic terms that Bill Clinton had used about himself after consulting a therapist. Dr. O'Brien knows that Clinton has had therapy since he mentioned it in a published letter to REASON (April 1994). On March 15, 1991, Clinton informed Charles Allen, an Arkansas educator, that he was "compulsively overactive." This appeared in Allen's book The Comeback Kid. On March 8, 1992, Peter Applebome reported in The New York Times Magazine that Clinton had told him that he had had therapy and had learned that his "compulsive and obsessive ambition" damaged his relationships. If Clinton wishes to tell the world about his psychological diagnoses and problems—and telling The New York Times is telling the world—Dr. O'Brien can have no ethical objection to my discussing them.

If he had read the article more carefully, he would also have found my grounds for assessing the severity of Clinton's condition. The Agenda by Bob Woodward was by no means the only source of information that I used, but it was a very significant source. The picture that emerged in Woodward's book was of a seriously disabled man. Mickey Kaus, a senior editor at The New Republic, reached the same conclusion in that magazine's November 28 edition—one month after my article appeared. Kaus described Woodward's book as portraying a disabled Clinton, but he tried to blame that portrayal on the president's political adviser George Stephanopoulos. Kaus wrote, "Bob Woodward's The Agenda described a near-dysfunctional president kept on track by Stephanopoulos' benign machinations." After making this charge, Kaus did not develop or prove it and never referred to it again in the article. Nor did he deny, or quote anyone who denied, that Clinton was "near-dysfunctional." I would suggest to Dr. O'Brien exactly what I suggested to Messrs. Turk and Smith: that he read Elizabeth Drew's new book. He will find further support for the portrait of Clinton in my article.

It apparently hasn't occurred to Dr. O'Brien that in his own field there are people who specialize in assessing the psychological state of foreign leaders to whom they have no personal access. They do it by poring over intelligence reports—which rely heavily on news accounts and other journalistic material—in an attempt to identify patterns of thought, emotions, and behavior. In a situation where access is impossible and yet some knowledge of a human psychology is needed, long-distance assessment is made. It is not "psychoanalysis." It is, essentially, a psychologically knowledgeable integration of observations by journalists.

Dr. O'Brien's own description of Clinton as "a megalomaniacal, insecure, distractable, habitual liar from a broken home," emerges from an integration of journalistic observations. It is psychologically deadly even without formal diagnostic terminology. (I assume he is using megalomaniacal colloquially rather than diagnostically.) What O'Brien really opposes is my use of diagnostic labels.

There is a term which is badly needed in the medical and psychiatric professions: the recognition diagnosis. It describes the response to those advertisements which consist of patterns of recognizable symptoms for heart disease, for cancer, for diabetes, for depression, and so on. The purpose of these ads is to teach laymen to memorize the symptoms so that they can rush themselves or someone else to a physician or a psychiatrist who will then make a true diagnosis and provide treatment. A "recognition diagnosis" provides just enough information to know that the problem is serious and to get someone to a doctor. We are constantly encouraged by more and more ads to make more and more recognition diagnoses of more and more diseases. You cannot logically teach laymen like me to recognize patterns or symptoms of diseases and then denounce them—or me—for making diagnoses and practicing psychiatry without a license. For the purpose of offering readers a recognition diagnosis, DSM-3R is perfectly satisfactory.

Dr. O'Brien's assumption that I did not talk to psychiatrists and therapists about what I was researching is unreasonable. I am a journalist with 50 years of experience, and it would have been inconceivable to me to undertake such a project without counsel and assistance from members of O'Brien's profession. He knows perfectly well that behind the scenes psychiatrists, like all other human beings, talk freely. They talked freely to me.

Further, I devoted almost a page of REASON to discussing the moral and political justifications for this project. If Dr. O'Brien does not agree with my reasoning, he should say so and explain why. He should not ignore it and keep reciting the sad tale of Barry Goldwater. Long-distance analysis was false in the case of Goldwater. It was true in the case of Nixon. His concern should be for truth, not conservative grudges.

There is a legitimate public concern raised by Clinton's behavior. Nothing catastrophic would occur within the country because of it: There are too many sources of power that compete with the executive. Clinton could sleep his term away and it wouldn't matter too much; in fact, the country might be better off. But he is our commander in chief. He has life-and-death power over Americans and millions of other human beings. It is preposterous to say that the press should not investigate his condition and that citizens do not have the right to know about it.

If Dr. O'Brien stopped calling what I wrote a "psychoanalysis," he would become less agitated. I didn't call it a psychoanalysis. It is not a psychoanalysis. It is a psychological profile. I did not think I was playing doctor. I was playing journalist, a role for which I am qualified.

To John Cronan: See my answer to Dr. O'Brien.

To Richard Vatz: See my answer to Dr. O'Brien. Also, see the letter from Michael Masora.

To Michael Masora: It was very generous of you to prepare so careful an analysis of your condition and to hope that it might help others. Even the short sections of your powerfully written letter that we are publishing will indeed help readers to understand why people with conditions similar to yours identify with President Clinton. I really do hope you will improve.

To all: I do not discuss letters from the people in the mental health field who have written to offer their own interpretations of Clinton or elaborations of the one I published. While I don't doubt that some of them are right, my discussion is restricted to the problems Clinton has publicly identified in himself.