It can be very tempting, even easy, to look at a famous musician and say “that guy is a total narcissist.” When you’re sitting around talking with friends, it’s an interesting topic. But should mental health professionals engage in this sort of speculation publicly?
This interesting piece from NY Mag considers a new book by Claudia Kalb, in which she examines famous historical figures and their behavior, which she then presents to mental health professional for a diagnosis. Andy Warhol Was A Hoarder: Inside the Minds of History’s Great Personalities sounds interesting. The article above cites an NPR interview in which the author says that Warhol saved all sorts of things “from receipts and junk mail to even pizza crusts. Warhol’s goal was to sell them eventually as artifacts of his work, but he also felt a strong attachment to the objects: In his journals, Warhol wrote, ‘I can’t throw anything out’; in another entry, he wrote, ‘I’d love to have a really clean space.’ But, as Kalb notes, ‘He could never do it.’“ That distinction, between being messy and having an emotional attachment to what some call “junk,” is, indeed, the key feature of hoarding.
The NY Mag piece also does a good job of examining the ethics of such investigations. Mental health professionals are ethically forbidden from diagnosing people that they have not examined personally. There is an important reason for this. While public figures may behave in a way that is consistent with a certain diagnosis, a clinician cannot know what this person is actually thinking until they speak with them and ask them. I would be worried that diagnosing someone you haven’t examined might pose a risk to them, as people tend to embrace or “own” a diagnosis. It’s not hard to see how an inaccurate diagnosis could impact someone, famous or not.
I also worry that some of the disorders that are discussed may have been classified as “disorders” since the person died, and I believe we want to be careful about judging someone’s behavior many years ago by modern standards. After all, many “mental illnesses” may represent behaviors that had reasons to exist many years ago and are no longer necessary for human survival. For example, post-traumatic stress disorder (PTSD) may have been necessary for survival eons ago before humans completely dominated the planet, but has become problematic now that we have few or no predators in our environment. Is it possible that a behavior that is a problem now served someone well in the past and might their accomplishments be diminished by adding a presumptive diagnosis of mental illness after their death? After all, we cannot personally know what a person’s everyday life was like in the past. Andy Warhol was never a hunter-gatherer, obviously; the point is times and standards of behavior as well as values change quickly and frequently.
I have attempted to provide education about psychotherapy as well as to address the ethical conundrum on this blog by looking at behaviors of fictional characters, such as Luigi from Super Mario Brothers. Though I make no pretense of “diagnosing” Luigi, the mock therapy sessions certainly show behaviors that could lead one to make a diagnosis.
This public diagnosing also may add to a perception that mental health professionals go around diagnosing everyone in their life, a perception I can personally attest is untrue. There’s no need to be uncomfortable or worry about this just because you have friends or family members who are mental health professionals. All that diagnosing would drive us crazy, trust me!
That said, all of the figures in the Kalb book are deceased, so there will be no impact on their lives. In addition, as the author states above “My goal, I hope, is that by reading about these people, there’ll be some less stigmatization of mental-health disorders.” I think this book may very well succeed in this aspect, which is important. One of the things I try to do with this blog is praise celebrities who are open about their mental health struggles, as I do believe that every person who speaks openly takes one step towards erasing the stigma of needing and receiving mental health services.
Mike McMahan is a psychotherapist in private practice in San Antonio, Tx.
Therapy Goes POP
Perspectives on therapy and mental health as viewed through the lens of popular culture