I have to wonder how helpful it truly is to be playing armchair psychiatrist, when you’ve never personally interviewed the person under discussion. Imagine all the things we could just hypothesize about any celebrity, based only upon a snippet of their public behavior (a snippet we carefully choose, of course).
There’s a profession that does something like this. They’re called publishers, and they publish tripe such as “Us Weekly” and “Star” magazine. They take a piece of gossip and write an entire story based upon nothing more than speculation, imagination and hype.
So I found it more than a little disappointing (but perhaps not surprising) to find a representative of the mental health profession, Dr. Keith Ablow, on Fox News Sunday night doing just that. He spoke during a “Medical A-Team” segment where a group of doctors talked about the vice-presidential debate.
Should a psychiatrist be discussing differential diagnoses of the Vice President of the United States — especially if they’ve never even met the man?
Of course, he prefaces his comments with a standard disclaimer media doctors often try to use to make it sound more ethical:
“I did not evaluate Joe Biden…”
Well, if you did not evaluate Joe Biden face-to-face, and you apparently know nothing about him (Dr. Ablow later claimed Biden’s blood alcohol level should also be checked, although it’s well-known that Biden doesn’t drink alcohol), what are you doing babbling about him on national TV?
Here’s the clip:
Now, tell me if that fits within the spirit of the American Psychiatric Association’s ethical principles:
3. On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it 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.
Dr. Keith Ablow acknowledges he’s never seen Joe Biden in a professional capacity. Yet, Dr. Ablow is discussing differential diagnoses about Biden as though he had. He’s suggesting specific psychiatric diagnoses to examine, without any knowledge or history of Biden’s medical or psychiatric background.
Instead, he’s doing it based on a single, solitary public performance. Would anyone feel comfortable being judged by a medical professional like Dr. Ablow based upon a single incident like this?
I should take all of the public interviews Dr. Ablow has given on Fox News, and in a purely hypothetical exercise, determine what sets of diagnoses we should consider giving him. I will be quick to say, “I’ve never examined Dr. Ablow, but… here are a set of differential diagnoses we should consider for him.”
But I won’t, because I don’t believe we should be playing armchair psychiatrist or psychologist or whatever from afar in this manner. It does nothing to help illuminate the debate, or to offer any actual insight into a person’s behavior. If anything, it only brings attention to yourself.
And perhaps that was the goal all along.
Read the full article: Fox News' Dr. Keith Ablow: Joe Biden May have Dementia
35 comments
I feel that this article is taking Dr. Ablow’s insights out of context. Why did you not mention that Dr. Ablow is offering insights as HE sees them, and offers that if a person were to come to him and say that his grandfather or father was acting out of character, laughing inappropriately, constantly interrupting and seemingly has no self control, Dr. Ablow would offer that all avenues should be explored. He went on to say that he would suggest to his patient that the person should have MRI’s, CT scans, psychological evaluations, etc,. He would leave no stone unturned until a true diagnosis was determined.
He was speaking in hypothetical terms.
He also explains at the beginning of the clip that Vice President Biden showed tremendous disregard for the perspectives of others, such as saying (for example) you graduated at the top of your class when in fact you graduated at the bottom. Dr. Ablow said “…In other words-don’t interrupt me with the facts..”
Dr. Ablow was asked to bring his psychiatric experience, to help us dissect and understand what may or may not have been happening “between the lines.”
He stated clearly that he was not there as a political consultant.
So, I feel that, ironically, this article is taking just a ‘snippet’ of information and again, ironically, practicing armchair analysis on a former colleague of yours.
We provided the actual video that appears on YouTube so the reader can decide for themselves.
Considering that Biden has no diagnosed psychiatric condition that has been disclosed, it’s no different than taking any politician, and suggesting you run through a whole list of diagnoses that could help explain the behavior you simply disagree with. Did Ablow offer any such diagnoses for Palin’s behavior? Or how about Romney’s (for instance, saying at one time 47 percent of the US will vote for Obama because they’re basically on government welfare, then distancing himself from such remarks once they became public — is that a sign of something psychiatric?? Someone who can’t stand by his beliefs once they are in the public spotlight?).
Because he appears to only offer the suggestion of a psychiatric disorder to politicians he disagrees with, that makes it very much a political opinion — and very little to do with the actual profession of psychiatry and medicine.
Remember, he’s the same guy who defended Gingrich’s cheating behavior (something that most mental health professionals would have a serious problem with), suggesting it might “making him a better President.” Uh, okay.
The actions above are unprofessional, deserve censure in some form, and if really fair and balanced as Fox claims, should be eliminated as alleged expertise commentary by respecting what are the standards of care and ethical expectations by the profession being called on for alleged analysis.
Frankly, not only with Dr Ablow but by others who have written here on matters that are not purely mental health in limits, if you write psychiatric/psychological opinion and then try to use your credentials as expertise and yet simultaneously claim opinion as just an average citizen, that is hypocrisy beyond pale. And I hope Dr Grohol gives that some thought before further posts presented here are done!
Besides, at the end of the day, neither political party is above reproach these days, the egos I observe very peripherally really do breach Axis 2 cluster B features, but isn’t that the beast we have come to expect of career politicians? It is inversely proportional how well someone allegedly represents us the longer such politician is in office. That is not offered by a psychiatrist, but by a voter of 30plus years experience. Hence why I do not, will not, and never will vote for anyone in office more that 12-16 years at any level of government. Fresh faces and opinions have a greater likelihood of representation, not resentment!
As a U.K based physician with 26 Yrs of experience I completely disagree with you. Dr Ablows conduct irrespective of partisan leanings was unprofessional and extremely unethical. The good Doctor Grohol is quite right and on point and I will explain why.
You can’t defend his actions by asserting his rights as a show guest / free citisen or with claims of hypothetical posturing as you stated above. Why? Because once he is introduced with the title Dr. and distinguished as a mental health professional all words that come out of his mouth carry a certain degree of gravity and convey an implied sense of credibilty. Its like having an Army General come on T.V and say well I am not speaking as a military professional but hypothetically speaking I think this military helicopter seems like a lemon and should be scrapped based on 5 minutes of footage.
The point is he is speaking on matters that he is deemed professionally competent and knoweledgable, as such even a minor statement carries some weight. I am not sure if you get my point, but the privilege to put the prefix Dr., Scientist, Accountant carries some responsibility that supercedes political quick points. The man is a disgrace to his profession and if he was in the U.K he would be facing some severe scrutiny. My 10 pence or 2 cents as Americans would say Ha!
I guess you missed the part where he said (paraphrased) If my patient told me his father or grandfather was laughing uncontrollably, interrupting constantly, and had poor self control I would have to suggest said person be evaluated completely with a full battery of tests. MRI’s, psychological testing, etc.
BTW, if you think Biden’s maniacal laughter was appropriate when the subject at hand was NUCLEAR WEAPONS, or if he just “wearing his heart on his sleeve” then I strongly disagree.
PS
Biden was acting crazy. That’s what he should have said, imo.
This so called doctor gives a bad name to the medical profession all together. Dementia, give me a break. Did he even go to medical school. He needs re-education if he thinks that was signs of dementia. Embarrassment.
Dr. Ablow knows, as does anyone in the mental health profession, that the statements he made were unethical according to the code of ethics he is bound to adhere to. No reputable mental health professional would have made such a statement in private, let alone on television. It must be concluded that he was more interested in casting unfounded aspersions on a political figure to conform with the well known bias of the Fox Network.
When I watched Dr. Keith Ablow speak about the debate, I took it as him doing what I believe most doctors would also do. “Wonder” Wonder, what is wrong with Joe Biden, why isn’t he taking this seriously, wonder why he’s laughing in such a weird way, about important issues?? I just thought he was naming a list of things that could medically explain such strange behavior.
I watched with many people, including facebook friends, and the only comments over and over again, was “what is wrong with Joe Biden, why is he laughing”,or “at what is he laughing? ” Not one comment about agreeing with his laughter, just confusion at what was so funny.
I know you don’t appreciate Dr. Ablow, and obviously don’t get along with him, but please lets not exaggerate what he’s doing. I don’t see you going after other doctors from CNN, Or MSNBC, just Dr. Ablow over on Fox.
Didn’t you think Joe Biden’s laughter was odd, most people did.
While we may agree that someone who “laughs too much” is “odd” (really, where do we draw such fuzzy lines…?), inappropriate laughter is not a diagnostic symptom of dementia. What are the two major symptoms of dementia?
– Memory impairment (Biden showed a strong recall of facts, as another commentator pointed out to Ablow in the clip)
– Cognitive disturbances characterized by one or more of the following: aphasia, apraxia, agnosia, or disturbance in executive functioning (Biden demonstrated none of these during his debate)
So frankly, either Dr. Ablow has questionable diagnostic skills in my opinion, or he made the suggestion knowing full well it would turn into a nice partisan sound-bite for the next day.
Since nobody except Dr. Ablow has suggested with any seriousness the Vice President is suffering from dementia, I think we know which way this episode went.
Dementia was one of many things he suggested. If I may ask, if our Vice President was Republican, would you feel the same way?
You’ve written several negative articles about Dr. Ablow, and yet, when others do the same thing on other subjects on tv, such as Dr. Drew, Dr. Phil, Dr. Oz etc…you stay silent.
Can you be honest, and explain why it is you dislike Dr. Ablow as much as you do. The articles you write about him, always come across very personal.
It would be different if you were being objective, but it never seems like you are with him.
PS
I’m not sure we are talking about the same clip. The one you posted was from Fox and Friends on Sunday morning.
The one you are referencing above is seemingly from another show altogether?
I apologize if I misunderstood, as I was quoting from an interview given by Dr. Ablow on Sunday morning.
“….So I found it more than a little disappointing (but perhaps not surprising) to find a representative of the mental health profession, Dr. Keith Ablow, on Fox News Sunday night doing just that. He spoke during a “Medical A-Team†segment where a group of doctors talked about the vice-presidential debate….”
I did not see the interview on Sunday where you mention other physicians were involved as well.
Maybe I misunderstood.
Hey John,
I tried to write something similar on the MediaMatters website, but it’s ridiculous Discus comments service doesn’t play nice with the iPad.
My suggestion was that he was likely in breach of both APA (if he is a member) guidelines, as well as his state medical board, and a US-based complaint ought to be attempted to see where it goes. Essentially, as you’re aware, media appearances and comments diagnostically about public figures are prohibited if you have not formally assessed because it conveys to the public abilities and skills the profession does not possess.
Will you or any reader in the state in which he holds his license make such an complaint?
Dr. Grohol, this is not shocker. We see it here at PC a lot. Every time a public figure is found to engage in non-normative and honor-deflating sexual practices, there’s some PC blogger or bloggers who immediately labels (or at least strongly alludes to) the person as a sex addict. And that’s without any more therapeutic time than Ablow spent with Biden.
True, n’est-ce pas?
First I think when a psychiatrist is invited to a TV show we expect him to tell us an opinion about a public personality and an opinion that’s ‘different’, somehow far from the opinion we expect from a journalist or politician, or actor. We want, as viewers, hear something about psychiatry and dr Ablow does exactly that. You can disagree, but what you do here, doctor Grohol, is casting attention on you, speaking of dr Ablow and insinuating he has no professional ethics. Biden is not his patient, so dr Ablow can go and say any opinion about him, as any free American citizen can do. Sorry to say you used your freedom to speak to vent your anger, may I say personal anger, and I’m sure you won’t accept and post this, showing this way your perfect ethics.
Actually doctors, psychiatrists, psychologists, social workers, etc. all have professional ethics that restrict their free speech, especially in this specific regard.
While I’m not aware of it being challenged in court, it’s something a doctor agrees to when they belong to a professional society (and sometimes such ethics are enforced by a state’s licensing board, sometimes not).
That’s a legitimate point of debate, but as far as I can tell, the AMA ethical principles limit physicians speaking about public persons from a medical perspective — offering their specific medical opinion about the person — to stop those who might suggest medicine can diagnose folks from afar. That’s just my opinion.
Facebookfriend: Dr Ablow is only one of a long line of uninformed doctors offering opinion with no medical evidence. That stuff usually ends up in less then reputable locations like tabloid magazines who love to rely on statements prefaced with “I have not seen the person in question”. We all know Fox News has a long history of blurring the line between reality and opinion.
In Italy, as in your country, we have psychiatrists who go on TV shows and are asked to evaluate public persons, like politicians, criminals ( in Italy most the same) and actors and actresses like lindsay lohan. He correctly stated he is not seeing Biden as a patient, so viewers know he is only stating his opinion. what makes this interesting is that when a psychiatrist looks at anyone of us, he can tell our issues from the way we open his door. We may like it or not, but politicians show their issues anytime and they made a tv series about body language. So, I think maybe Fox asks dr Ablow to unmask only democratics, but it’s a fact there’s not much we can hide when a psychiatrist watches us.
“… but it’s a fact there’s not much we can hide when a psychiatrist watches us.”
Which is exactly why, in the U.S., there are prohibitions against psychiatrists doing this sort of thing — to prevent magical thinking that suggests psychiatrists (and other mental health professionals) can peer into a person’s soul and completely “psychoanalyze” them, just by watching them talk on TV for a few minutes.
It’s my opinion that by disclaiming you’re not going to engage in psychiatric speculation about a politician or celebrity you’ve never met, and then going ahead and doing just that, is intellectually dishonest at the very least.
If I say to someone, “Don’t take this personally, but…” and then engage in a long diatribe about someone’s personal habits, the disclaimer isn’t going to magically negate my personal comments. That’s called “magical thinking,” and that actually is symptomatic of something… 😉
APA has a Media Referral Service, where media can call if wanting to talk about news that matter from a psychological perspective. Eliot Spitzer’s case, interesting also Vogue Magazine, was one of the topics. I think if dr Ablow should talk of Republicans, you had nothing to say. Fox is republican and if they call you, they ask you to talk of good republicans and naughty democrats. Letterman always makes fun of republicans, sometimes in a hard way. So what? They’re on tv and they say what they want. I searched, but found no APA document about. If you have any, pls post it, cause nowhere it’s said a doctor can’t express opinions freely. Or, if APA should have such a statement, where has America gone? The freedom and stars and stripes etc? About magical thinking, dear doc, if your patients never had the sensation you could read them and understand to the core of their being, it’s a shame. You can joke about, but as a matter of fact, I remember when I was at the university and was out with students from psychiatry they really had some tools more than others to understand and once I dated a guy whose daddy was a psychiatrist, he used to tease me, telling me things I was SURE I was keeping inside. My boyfriend once said “Don’t worry, apart from not telling him lies, he is a good man” If for you it’s magical thinking, you don’t know lots of empathy between patient and doctor. You can go on insinuating about dr Ablow and his mind, but your passive aggressive emoticons say a lot about you. Oh, just made some test at body language institute that inspired Lie To Me, I got 70 over 100, good result. I’m not even a psychiatrist, but I know policemen who can tell if you cheated on the parking ticket. Sorry for not knowing the passive part, I’m only aggressive, but I really admire dr Ablow
Dr Grohol,
I completely agree with your view on this matter and so do my mates (all health professionals including a neurologist) across the pond i.e. Glasgow, Scotland – granted ours is a non-American perspective.
I watched the clip and I was stunned, not just bcos of the ethical misgivings (I too am a proud member of the medical profession OBGYN though not the behavioural field), but the illogical and completely absurd rationale behind Dr. Ablows reasoning / assertion. For christ sake anybody with an ounce of psychological insight on body langauge cues would explain that Biden wears his heart on his sleeves and reflects his immediate reactions non-verbally i.e. laughter to display disbelief etc…suggesting dementia is an amazing stretch and strongly calls into questions this quack doctors professionalism.
Great article by the way 🙂
I’m no psych doc, but I do have to interview people for clearances and I have to know the key signs besides what a person says. Laughter in excess can be just an expression of nervousness or it can mean they are uninhibited by some source of medication, legal or otherwise. I have no need to express all that I saw, but enough to say that an average Joe on the street with any sense will see that Joe Biden was not “normal”. Of course Fox News or any other news source isn’t going to go out on the street and ask that average Joe for a professional opinion. They want someone who has some degree of authority and knowledge that is accredited to make such statements of observation. Not a diagnosis. I consider his statements were his personal observations, not him trying to diagnose Biden. We can all see he wasn’t on his best, whatever that should be. To me Biden showed no decorum, respect, protocol or otherwise. The man is truly disturbed and I wouldn’t let him in any of the areas on my facility that requires a clearance.
Yes, and when “an average Joe on the street” has to read into other people’s behaviors and make judgments about what “normal” is and is not, we have the kind of prejudice and discrimination that impacts anyone who actually has a mental health concern.
I’d agree with you about Ablow just offering his personal observations, except that he is the one who specifically mentioned the words “differential diagnosis” and then offered specific diagnoses! I’m not putting words into his mouth — these are his words.
Furthermore, why would he be in a segment called the “Medical A-Team” if he weren’t there to offer his professional opinion — not his personal observations?
There appears to be a disconnect there.
As for diagnosing politicians with afflictions, I’ll leave that to the brain trust at Fox News.
Dr Grohol, You are wise beyond years and as a fellow doctor from the U.K I must (professionally speaking) agree with your assessment in response to Jim. I am a bit taken aback as to how Bidens behaviour appears abnormal I found him quite normal and if anything unusually emotionally transparent for a politician knowing the typically exaggerated conveyance of detachedness typical amongst most American politicians.
Americans should try watching English parliamentary debates or better yet typically mild mannered Koreans engaged in political justling and might just end up reevaluating Biden as completely sane.
He said he had dementia. That is a diagnosis usually made by testing an individual not watching a show and deciding he is demented. I work in the medical profession and his flippant comments are embarrassing to himself and the profession as a whole. He is irresponsible.
Dr. Ablow’s suggestion/possible diagnosis of dementia here is totally off the wall and inappropriate. What it does, however, is give you a work sample of Dr. Ablow’s thinking. I certainly wouldn’t trust this man’s judgment for anything. His comment does make me wonder if he might be projecting, however. He may have dementia on his mind for some reason totally other than anything that has to do with Joe Biden!
How does this differ from Psych Central blogs about celebrities? The one about Mel Gibson (narcissistic vs. bipolar) comes to mind.
There are others too.
? ? ?
This is interesting, because I found Joe Biden’s performance to be cogent and endearing, as did most of my friends. It certainly didn’t seem to us that he needed to be “diagnosed” for something.
Of course, we are all a bunch of lefties, which to some means that we must suffer from dementia, delusions or some other terrible malady. I feel much the same about those on the right, though I mostly attribute their strangeness to fading privilege and an irredeemable moral lack.
Maybe we really do live in parallel realities.
“I feel much the same about those on the right, though I mostly attribute their strangeness to fading privilege and an irredeemable moral lack.”
Empirical data show the left is less well informed of the oppositions perspective than vice versa. And most conservatives are not people of privilege.
Roughly half the country would agree with your statement by simply replacing ‘right’ with left and ‘privilege’ with influence. So like adolescents we argue back and forth?
I see that some people on this post are reticent to give a differential diagnosis of Dr. Ablow himself, so I’ll do it. Narcissist. DSM-IV-TR 301.81
http://www.forbes.com/sites/henrymiller/2012/08/20/joe-bidens-gaffes-call-for-a-thorough-neurological-examination/
Citing another conservative physician who is arguing from his politics — not from normal physician practice behaviors (since 99 percent of physicians would be uncomfortable with diagnosing a complete stranger from afar) — doesn’t really help here. Two wrongs don’t make a right.
“Citing another conservative physician who is arguing from his politics…”
Curious you never responded to Elizabeth, 10:45 am on October 16th, 2012. “If I may ask, if our Vice President was Republican, would you feel the same way?
You’ve written several negative articles about Dr. Ablow, and yet, when others do the same thing on other subjects on tv, such as Dr. Drew, Dr. Phil, Dr. Oz etc…you stay silent.
Can you be honest, and explain why it is you dislike Dr. Ablow as much as you do. The articles you write about him, always come across very personal.
It would be different if you were being objective, but it never seems like you are with him.”
Keith Ablow bows to no man except Roger Ailes. For Roger, Keith Ablow job experience keeps him coming back.
I have been seeing psychiatrists for some 21 years for mental illness and I am appalled at how Keith Albow and Dr. Phil have made their $$ remotely diagnosing individuals. They believe it makes it “O.K.” if they first issue a disclaimer before tearing in to someone on national T.V. Shame on them!
As a nonprofessional, but as an individual who has worked in the mental health field along with professionals for over 20 years, I find Dr. Albrow’s opinions of grave concern. None of the mental health professionals I worked with would ever consider going on television to talk about a specific person’s behavior even if they had properly evaluated that individual. In fact, all the professionals I worked with refused television interviews/news interviews because of misinterpretation by nonprofessionals. I have long wondered why the psychiatric profession has not called Albrow to task for Albrow’s very nonprofessional behavior.