Anyone who has followed the presidential campaign of 2008 to any degree (or who has simply turned on a cable news channel, or read their local newspaper) has heard time and again that this election is about one desperately longed-for thing: “change”. Nowhere is this quest for the elusive element of “change” being played out more than in the race for the Democratic presidential nomination, where exit polling in Democratic primary contests suggests that the Democratic Party electorate is crying out for “change”. As such, the natural conclusion drawn by many of the pundits and political writers following the race for the White House (and shaping political discourse), is that the lone candidate from either party who truly represents “change” is Sen. Barack Obama. After all, the evidence brought to bear is that Sen. John McCain has served in Washington D.C. for 24 years, invalidating his track record of being a “change agent”, and Sen. Hillary Rodham Clinton, having been the wife of a former president and First Lady, represents the past. In contrast, Sen. Obama has followed a meteoric rise from a simple community activist to state politician to U.S. senator, all in the span of 12 years. If one just looks at this argument on its surface, then it could be concluded that yes, Sen. Obama, of the three candidates left in the campaign for the presidency, is most likely to bring about what so many political pundits tell us that our country desperately needs, “change”.

However, is “change” as it is being presently construed, and as it is being offered by Sen. Obama, the prescription that our country needs to navigate the uncertain world of 2008? If one digs deeper into the arguments for “change”, they can be deduced to ideas such as that our nation needs to turn the proverbial page, or that the larger world is expecting us to “reengage” with it, or that we must “transcend the politics of the past”, and other such vagaries. It is as if the “change” that is being offered is no more than change for its own sake.

As a psychiatrist, and an American, I view this quest for “change” both with interest, and trepidation. In fact, if the Democratic Party and its constituency were my patients, I would tell them that they are afflicted with an overvalued idea, and that this idea may lead to self-destructive behaviors in its service. Also, should Sen. Barack Obama win the presidency, then this overvalued idea could lead to disastrous consequences not just for a political constituency, but for our nation as a whole.

The overvalued idea as a concept in psychiatry was first defined by the nineteenth century German psychiatrist Carl Wernicke. The term refers to a thought or belief shared in common with other members of a society, but in a particular group within that society, is held with an intense emotional, fanatical zeal. This type of belief can lead to dominant, and ultimately, self-destructive behaviors, in its service. An overvalued idea should not be confused with a couple of other common psychiatric terms, a delusion, or an obsession. A delusion is a fixed and false belief that is unique to the individual; an obsession is a thought, often intrusive, that although can dominate the mind like an overvalued idea, is unwanted by the individual, whereas an overvalued idea is not only wanted, but is amplified and defended against all reason. In the clinical world, an example of how destructive and life-threatening an overvalued idea can be is anorexia nervosa. In anorexia nervosa, the patient becomes invested in the idea, common throughout much of our society, that “thin is in”; however, the patient embraces this idea with such zeal that they starve themselves, abuse appetite suppressants, and/or engage in other similar behaviors, all in the service of this singular idea. If untreated, which in severe cases can require twenty-four supervision to interrupt the behaviors, anorexia nervosa carries a mortality rate of 6-20% (based upon all epidemiological studies of the condition).

In the non-clinical world, the concept of the overvalued idea has been convincingly applied by Dr. Paul R. McHugh, a distinguished Service Professor of Psychiatry at the Johns Hopkins University School of Medicine and the former psychiatrist-in-chief at the Johns Hopkins Hospital, to explain the nature of terrorism, in his article, “A Psychiatrist Looks at Terrorism”, which appeared in the Weekly Standard in December of 2001. In this treatise on the nature of Islamic terrorism from the perspective of a psychiatrist, Dr. McHugh argued that the events of September 11, 2001 were the destructive consequential behaviors performed in the service of the overvalued idea that American society and the freedoms that it offers is not only contrary, but heretical to the interpretations of Islam and world-view of Islamic terrorists, and as such, this society must be destroyed.

How then does the concept of the overvalued idea apply to the presidential contest of 2008? In this campaign, the overvalued idea afflicting a significant proportion of the voting public, and that is being pushed by a large portion of political writers, is that of “change”. This belief stipulates that our country and its ideals have been decimated by the current political establishment, and that in order to repair the damage done and regain the respect of the world-at-large, that we as a nation, must embrace someone, who although has limited experience as a leader and is not fully forthcoming with his plans for the country, is promising a “new kind of politics”, and “change”, as a remedy. To an extent, the actual manner of “change” is inconsequential, as long as there is “change”, and in order to enact this “change”, then one most surely must cast their ballot for Sen. Obama.

What do we truly know about the “change” that Sen. Obama will attempt to bring about should he become the 44^th president of the United States? The candidate and his advisors have provided us with some insights. Sen. Obama has proposed a foreign policy that centers on meeting, without precondition, numerous enemies of our country who regularly denigrate our values and beliefs on the world stage, yet eagerly crave the legitimization that a face-to-face meeting with the leader of “the last remaining superpower” would provide; in addition, his plans for upholding our national security are trapped in generalities of wishing to undo the past rather than living in the present world, and are marred by naivety as to the nature of those throughout the world who would seek to destroy us. In terms of domestic policy, the “change” Sen. Obama offers is the same neo-Marxist redistribution of wealth as a cure for societal ills (as evidenced by his remarks in campaign “stump” speeches in which he would “roll back President Bush’s tax cuts for the wealthy” followed by the statement that he would then offer tax cuts to those families making less than $75,000 per year, defining the term “wealthy” at that income line) that has been offered by Democratic presidential candidates for decades, and that has both been soundly rejected by voters in the past, and has failed history’s tests for success. Finally, the “new kind of politics” that the junior senator from Illinois is claiming to offer is one that “rises above negativity” and is impervious to corruption; however, Sen. Obama’s dubious financial dealings with the indicted Tony Rezko, the recent insults levied by his senior advisors to his opponent in the Democratic nomination contest, as well as statements made by both his senior economic advisor and a former foreign policy advisor to both governmental and media representatives of foreign countries that suggest several of Sen. Obama’s primary policy positions are nothing more than political posturing that will not translate into real policy should he be elected, suggests that the senator’s “new kind of politics” is nothing new at all.              

Yet, despite what is known about the “change” that a President Obama would bring, he is not only leading the Democratic presidential candidate delegate count, but in current opinion polls is leading Sen. John McCain in hypothetical head-to-head match ups. While Sen. Hillary Rodham Clinton’s clearly liberal policy positions would at a minimum be problematic, and at a maximum, ruinous, at least she is not misleading the voters by basing the premise of her campaign on the idea that she is offering anything truly unique other than her gender. Although not without his critics, most would agree that Sen. McCain represents a steadier and more knowledgeable candidate for the presidency, and for those that are looking for “change”, actually has a track record of accomplishing real, not hypothetical, change. In many ways, this submission to the dominant idea of “change” is similar to the belief above all else by the anorexic that she must avoid becoming “fat”, and despite living at a dangerously low weight, and even when confronted with tangible evidence of her impending demise such as extreme electrolyte abnormalities and electrocardiographic changes, she insists on remaining on the path to achieve “thinness”.  In the same vein, Democrats and even many so-called independents are willing to pull the lever for Sen. Obama, despite the growing evidence that his election could not only be disastrous to the Democratic Party, but also to the country as a whole, all in the service of the belief that “it’s time for a change”.

In many ways, the tendency to be overcome by the overvalued idea of “change” for its own sake is a uniquely liberal phenomenon, one rooted in making decisions based on feelings rather than on thoughtful deliberation and reason. However, succumbing to an overvalued idea can have catastrophic consequences. To an anorexic, it can mean death. One shudders to think what consequences may arise from a national submission to the overvalued idea of “change” for our country.