"A Formal Intervention with a Dry Drunk President"

Pink tries it her own way: "Dear Mr. President." (video).

Katherine van Wormer takes on the problem from a different angle:

One of the rituals well known to the addiction treatment world is the formal Intervention. The classic Intervention starts with meetings of concerned significant others that are called during a time of crisis. The result is a confrontation of the individual in trouble and an ultimatum of some sort for a drastic change in course (the most famous examples are Interventions of Betty Ford and Elizabeth Taylor for pill use and drinking.)

The long-anticipated report of the Iraq Study Group has been likened in some media reports to the classic treatment Intervention provided to drug users and alcoholics who have "hit bottom." Seething in its criticism, the report (Intervention) made a number of take-it- or-leave-it recommendations. "This is not like fruit salad," the head facilitator later explained; the recommendations must be followed as a whole. Characteristic of a person with an addictive mentality, the president responded in a state of denial as do the "enablers" around him. His supporters are getting fewer and fewer, however. And even his father recently broke into tears. We will return to that later.

The addictive mentality I am talking about is a cognitive impairment that is associated with alcohol-drug use, and may have preceded or followed the addictive behavior. George W. Bush, over his lifetime, has gone from one extreme-extensive and long-term binge drinking and at least some cocaine use-to another-affiliation with religious fundamentalism and authoritarian belief systems that cannot be explained by his religious upbringing. From an elitist background, the junior Bush was able to build a political base from a cultural group that was arguably alien from his own. (See What's the Matter with Kansas?)

For an understanding of this phenomenon of how the drinking and drug use affects patterns of thinking, we need to look at brain research. The most recent brain research, now revolutionized by technological advances in brain imaging, confirms what members of A.A. have known for years, labeled by them, the dry drunk phenomenon. Rigidity, poor impulse control, grandiosity, and all-or-nothing or black and white thinking are the classic characteristics. (See "the dry drunk syndrome" on google.) We now know that once the heavy drinking and/or other drug use stops, a certain amount of cognitive impairment may persist. We also know, however, that the brain can actually be "rewired" through cognitive work.

"You've got to work at it." This is a commonly heard saying of George W. Bush. One thing he has not worked at, however, is what is sometimes called in alcoholism treatment parlance, "the second recovery." Treatment centers specialize in cognitive work, as does A.A., in effect, aiding persons in recovery to replace irrational, grandiose, and self-centered thoughts, with healthier and more moderate ways of thinking.

The kind of intervention that our president needed was a personal intervention, one aimed at the reasons that Bush fool heartedly and dishonestly (pushing for false intelligence assessments of the international situation) led the nation in a fantasy mission that was doomed to failure against "evildoers" in the Middle East. As I described as early as 2002 and as psychiatrist Justin Frank later, in Bush on the Couch, also concluded, to understand the motives behind the ill-fated invasion of Iraq, we have to consider Bush's role in his family, the unique psychological dynamics. As any Bush biography makes clear, the younger Bush was not only named for his father, but he was somehow destined to follow in his father's footsteps most of his life- at Andover, Yale, as a military pilot, in the oil business-only to fail at each juncture until he would enter politics and as commander- in-chief be able to stride triumphant in 2004 and declare "mission accomplished" on the carrier flight deck. Then he would have proven himself to his father and to the world.

In December, 2006, the elder Bush's tears shed at the tribute to his son, Governor Jeb Bush, told it all. "The true measure of a man is how you handle victory, and also defeat"-these were his exact words uttered at the moment that he got too choked up to continue. Though his loss of control was later claimed to be related to his younger son's (Jeb's), earlier defeat in a governor's race in 1994, it seems far more likely that his tears were shed over the disgraced presidency of his elder son and in recognition for the significance of this debacle for the entire Bush dynasty.

In the future, it will be left to psychologists and historians to ponder the real reason for George W. Bush's selection as members of his team, the very men like Cheney, Wolfowitz, Powell, and Rove, who, strikingly, had served under his father. Even Rumsfeld also had a historic relationship with Bush, Sr., albeit a problematic one. Above all, the challenge to psychologists and historians will be to ponder the real reason why the younger Bush was driven to an unnecessary and unbelievably costly war "mission impossible." The Iraq Study Group, which, interestingly, was headed by Bush Sr.'s former secretary of state, James Baker, was summoned in desperation to find a way out of a disastrous course, failed to tackle causality, which, in the final analysis is the most significant issue of all.

Howie opinion: The only practical intervention at this point for this patient must rely on the legal and political system, not the treatment model or a tragically beautiful song.