PSYCHOTICVISITORSTOTHEWHITEHOUSE

JOSEPHA.SEBASTIAN!,

M.D.,

iu

JAMESL.

FOY,M.D.

Thisstudydescribesanunusualgroupof

hospitalized

patientswho,withfewex-

ceptions,insisted

seekinga

personal

interviewwith

thePresidentoftheUnited

Statesathisofficialresidence,the

White

House.SecretServiceagentsand

White

Houseguardsmetwitheach

visitorini-

tiallyandweighedthepossibilityofseriousmentalillnessbecauseof

thevisitor’sun-willingness

toleaveorhisreasonsfor

trying

tosee

the

President.

Afterfurther

explorationthevisitorwas

takenintocustody

and

admitted

tothe

District

ofColumbiaGeneralHospitalundertheemergencyhospitalizationpro-visionsofthelawgoverningmentallyillpersons.Inalmosteveryinstanceofad-missionofa“WhiteHouseCase,”thepatientreceivedahearingshortlyafterhospitalizationbeforetheCommissiononMentalHealthoftheU.S.DistrictCourtfortheDistrictofColumbiatoconsidercivilcommitmentandfurtherhospitaliza-tion.Thosefewpatientsnotkeptforsuchahearingweredischargedontheir

own

ortheirfamily’sresponsibilityafterabriefperiodofobservation.ThepatientsdesignatedhereasWhiteHousecasesdidnotincludepersonscon-cerned

with

simplegrievances,actsofpoliticalprotestorpicketingattheWhiteHouseandchargedwithacriminaloffense.Rather,theyconstituteaselectgroupofprofoundlydelusionalindividualsseekinganexclusivepersonalencounterwiththePresidentandanextraordinaryassociationwiththecomplexlysymbolicofficeofthePresidency.Furthermore,thesepatientsactedupontheirdelusionsinsuchawayastoincurgreatpersonalexpenseandrisk.Manyjourneyedlongdistances,sig-

Readatthe121stannualmeeting

theAmeri-

can

PsychiatricAssociation,NewYork,N.Y.,May3-7,1965.Dr.SebastianiiswiththeUniversityofCin-cinnatiCollegeofMedicine.Hisaddressis3333VineStreet,Cincinnati,Ohio.Dr.FoyiswiththeGeorgetown

UniversitySchoolofMedicineand

theDistrictofColumbiaGeneralHospital,Wash-ington,D.C.naling

theirrequesttoseethePresidentincommunicationssentdaysandhoursinadvanceoftheirarrivalatthe

White

Housegate.Thesinglemindednessof

theirpurpose

oftenflewinthefaceofacoldly

frustrating

reality.Thepaperisdividedintofive

parts:

1)areviewofanearlier,similarstudy;2)ananalysisofthehospitalrecordsof40WhiteHousecasesadmittedin

1960

and1961;3)areportof

psychiatric

inter-

viewswith

tenconsecutivepatientshospitalizedbetweenOctober1andDe-cember31,1963;4)adiscussionofthe

material;and

additionalhypotheses

In1943,Dr.JayL.Hoffmanpublished“PsychoticVisitorstoGovernmentOfficesintheNationalCapital”(2).Hesurveyedthechartsoftheyears1927and1937atSt.ElizabethsHospital,Washington,D.C.where,inyearspast,WhiteHousecaseswerehospitalized.Ofthe53caseshedis-cussed,only28wereactuallyfromtheWhiteHouse;otherswerereferredfromtheTreasuryDepartment,NavyDepart-mentandavarietyofotherdepartmentsofthegovernment.Dr.HoffmanfelttheWhiteHousecasewasindistinguishablefromtheothersand

his

studydescribedthegroupasawhole.Mostofthepatientswerewhitemales;theiragesrangedfrom19-70,averaging44.Twenty-fourweresingle,15weredivorced,11separated,fivewidowedandfivemarriedatthe

time

ofadmission.NewYorkandCaliforniaweremostfrequentlytheirhomestates.Sixteenofthe53hadbeenbornoutsideoftheUnitedStatesandeightothers,althoughbornhere,hadatleastoneforeign-bornparent.Twenty-twohadbeenpreviouslyhospitalized.Thepatientshadpooremploymentrecordsandtwo-thirdswerenotself-supporting.Twenty-ninewereProtestant,19Catholic,twoJewish,onefollowednoreligionandinonecasetheinformationwasunknown.TheirpurposeincomingtoWashingtonwastoobtainrelieffrompersecution(21cases),togiveadvice(7cases),tocollect

679

680

PSYCHOTICVISITORSTOTHEWHITE

HOUSE

[December

large

sums

ofmoney(5cases),todisplay

orsellabizarreinvention(5cases),tobesworninasPresident(2cases)

Infour

cases,thedelusionswerenotreported.Three

ofthe

53patientswere“com-bative.”Thediagnoseswereasfollows:

dementiapraecox,paranoidtype,23cases;

dementiapraecox,othertypes,12cases;paranoia,paranoidcondition,sixcases;

manic-depressive,manic

type,threecases;

andorganicbrainsyndrome,ninecases.

Tenpatientswererecoveredenoughtobe

dischargedbuttherestwerehospitalizedat

St.Elizabethsorinhospitalsintheirhome

stateforlongerperiodsoftime.Throughoutthepaper,Dr.Hoffmanmadecommentsandobservationsandofferedmanyhypotheses.Theadmissionrateandthecontentofthedelusionsofthesepatientsfluctuated“accordingtothe

personalityof

thePresidentialincumbent.”

Althoughthepatientswere“quiet,pleas-ant,congenial,cooperativeandwellbe-haved,”heconsideredthem“potentiallythemostdangerousofallpatients”becauseoftheirlackofinsightandbizarreideas.Ofthe40WhiteHousecasesadmittedin

1960

and1961,38chartswerereviewed.Onlythepatient’sname,sex,dateofad-missionandthedispositionwereavail-ableintheothertwocases.Onepatientwasadmittedtwicein1960,andanotherpatientwashospitalizedoncein1960andtwicein1961-threetimesaltogether.Un-likeHoffman’ssample,whichincludedvisitorstoallgovernmentaldepartments,thecasesincludedinthispartofthestudywereWhiteHousecasesexclusively.In

1960,

whenMr.EisenhowerwasPresi-dent,eightpatientswerehospitalized;in1961,theinauguralyearofMr.Kennedy,32patientswereadmitted.Dr.

Hoffman

didnotdistinguishthepatientsof1927fromthoseof1937,althoughhecommentedthatthepersonalityofthePresidentmightbeanimportantfactor.BetweenthePresi-dentsof1960and1961therewasagreatcontrastinage,religion,politics,personalityandmanyothercharacteristics.Anyoneofthesemayhaveinfluencedtheadmissionrate,andotherfactorscouldnotbedis-counted.Admissionswerehighestinthespringandsummer,andespeciallyAprilandMay,butdidnotincreasesignificantlyattimesofnationalmoment,suchasthe

InaugurationortheBayofPigsInvasion.Furthermore,admissionsinlate1963,thetimeoftheassassinationofPresidentKennedy,causednochangeinadmissionrate.This

iscontrary

toHoffman’shypothe-sis.

Twentypatientswerebetween30and50yearsold.Thereweretwoteenagers,threeintheir70sandone86,withanaverageageof44,thesameasintheHoffmanstudy.Twenty-sixweremenand

14women;32werewhiteand

sixNegro.Whitemales(32cases)madeupthe

largestpartofthisgroupaswellas

Hoffman’s.

HalfofthepatientslivedinNewYork(7),Pennsylvania(6),Ohio(4)orMassa-chusetts(3),whiletwocamefromCanada.NoneofthepatientscamefromCali-fornia.Elevenofthe38wereforeign-born;thishighincidencewasalsonotedbyHoffman.Nineteen

ofthe38patientswereProtes-tants,10wereCatholics,twoJewish,oneGreekOrthodox,oneatheist,andthein-

formationwasunknowninfivecases.NineofthetenCatholicswereadmittedin1961.Eighteenpatientswereunmarried,eightmarried,sevendivorced,fourwid-

owed,andthemaritalstatusofonepatient

wasunknown.

Allthepatientsweredelusional.Four-teenfelttheywerebeingfollowedorpersecuted.Sevencametohelpthecountryinsomeway.Three

ofthese

broughtmessagesfromGod,oneclaimed

tobeJesusChrist,onereportedanelabo-

ratespyringsurroundingherPennsylvaniafarm.

Anotherhadsuggestionsaboutcom-

batingtheRussians.

Fivepatientscametocollectfortunesinmoneyorland.ThreeclaimedtheywerethePresident,onemaintainedthatshewasmarriedtothePresident,anda75-year-oldlady,whorefusedtobelievethatMr.

Eisenhowerwasnolonger

inoffice,claimedtobethePresident’smother.

An18-year-oldboyhadfamilyproblems

whichhewantedthePresidenttosolve,andamiddle-agedNegromanwantedthePresidenttoreturnhimtothewhiterace.Twopatientsconsideredtheirmission“topsecret”andrefusedtorevealanydetails,

1965]

JOSEPHA.

SEBASTIANI

ANDJAMESL.FOY

681andintwocases,the

specific

contentwas

notknown.

Twenty-oneofthepatientsadmittedtheyhadbeenhospitalizedatsometimeinthepast,butthenumberwasprobablymuchhighersinceonlyfivedenied

itand

theinformationwasnotrecordedin12cases.

Thirty-five

ofthepatientsweredi-

agnosedassuffering

fromaschizophrenicreactionand32ofthesewereofthepara-noid

type.

Theother

three

were

classifiedchronicbrainsyndrone,involutionalpsy-

choticreactionwithchronicbrainsyndrome

andalcoholicintoxication.Thirty-twopa-

tientswerecommittedfor

furtherhospitaltreatmentandnineweredischargedin

the

care

ofrelativesandfriendsforcon-tinued

treatment.

Onlytwowerereleasedontheirownresponsibility.

Ingeneral,Dr.Hoffman’spatientswere

moreconcernedwithpensionsandinven-tionsandlesswithdelusionalreligiousand

persecutorybeliefs.Perhapsthiswasindic-ativeofthenationalconcernofthoseyears,orpossiblyafunctionofthenon-WhiteHousecasesincludedinhissample.

Aninventormightpreferto

visit

thePatentOffice,whereasa

messengerbearingin-

formationaboutaconspiracyorprophecymightmorereadilygodirectlytotheExecutiveMansion.

Allthosepatientsadmittedbetween

October1andDecember31,

1963

whohadbeenconnectedinanywaywiththe

White

Housewereinterviewed,usuallyfora60-to90-minuteperiod.Eightofthesetenpatients

hadattemptedtovisitthe

Presidentandone(Case3)calledthepolice,announcinghisintentiontodoso.Theotherpatient(Case4)wasadmitted

aftercausingadisturbance

inthe

WhiteHouseitself.Together,thesetencasespro-videagoodsamplingofthevarioustypes

ofpatientsreferredtothehospital.

Case

A28-year-oldwhiteman,hospitalizedtwicethepreviousyear,heardvoices

callinghisnameandfeltpeoplewerelaughing

athim.Fortwoor

threeweekshehadbeenaware

thatsomeofthepeopleinhishome

townwereactingstrangelyandothershadcompletelydis-appeared.

finally

realizedthat

Commun-ists,maybeCatholics,“weredopingthefood”sothatpeoplewererobbedoftheircourageandweredoingwhat

theyweretold.He

startedtoWashingtontwoweeksbeforead-missionbutlost

his

courageduetothe“dope”

and

turnedback.Hearrivedonenightand

sleptinhis

truck.At

9a.m.hecalledthe

WhiteHousebecause“thePresidentisthebiggestauthority.”Hedidnotconsidervisit-ingtheFBIorCongress.Hewasamazedwhenhewasturnedawaybytheguardatthegate,andhereturnedat10a.m.inhistruck,crash-ingitthroughtheirongates.Hewasappre-hendedandhospitalized.Thepatientrealizedhecouldhavebeenshotorinjuredbutfeltadyingman’swordsmighthavebeenbelieved

morereadily.ThepatientadmittedhewouldtrythesametacticsagaintogethismessagetothePresident.Diagnosis:schizophrenic

re-

action,paranoidtype.

Case2.

This28-year-oldwhitewomanwasawareofthreeyearsof“infringement”againsthersincethetimeofherlasthospitalization.ShewantedmoneyfromthePresidenttopayforthisviolationofherrights.Sheonlycon-sideredseeing“theheadofthegovernment,”

the“electedhead,”andshephonedthe

WhiteHouseshortlyaftergettingoffthebus.Thenextdayshevisitedinperson,praying

aloud,

commenting

“Mysoulwentoutofme.

-.-

haveseenGodfacetoface.”Onadmissionto

thehospitalshe

wasacutelypsychotic.

Thispatientconsideredthepsychiatricin-terviewanother“infringement”andon

twooc-casionscouldtolerateonlytenminutesbeforeleavingtheroom.Diagnosis:schizophrenicre-action,paranoidtype.

Case

Amiddle-agedwhitewoman,German-bornbutaresidentoftheUnitedStatesfor15years,claimedshehadbeentestedforoverninemonths

fora

special

government

job.Thetestwasbeingconductedby“Mr.Alweiss,”whocausedhertolosejobsandtriedtofoolherbyhavingpeoplemasqueradeasothers.SevenmonthsearlierthepatienthadcometoWashingtontoseetheAttorneyGeneralbutreturnedhomewhenherattemptwasunsuc-cessful.Becauseshelostanotherjobandneededmoneybadly,shedecidedtostraightenthingsoutonceandforallandreturnedtoWashington14daysbeforehospitalization.ShespenttwoweekstryingtoseevariousSen-ators,CongressmenandtheAttorneyGeneral,visitingtheCapitoleveryday.Shewrote

the

PresidenttwiceaboutherdifficultyandtouredtheWhiteHouseduringvisitinghoursthedaybeforeadmission.Onhervisitthenextdaysheattractedtheattentionofanattendantandwashospitalizedaftersherelatedherstory.Shehadoneprevioushospitalizationearlierin