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President Bush’s recent comment that the US is “kicking ass” in Iraq raises the concern that the man running the most powerful nation in the world may be clinically insane.

President Bush recently told Australian Deputy Prime Minister Mark Vaile that the United States is “kicking ass” in Iraq. This was after a month, August, which saw the second-highest level of civilian deaths of the year, and in a year in which the number of US soldiers killed is on pace to be the highest since the war began.

If that’s “kicking ass,” one has to wonder what getting our asses kicked would really look like. It also raises a deeper question about Bush’s mind state: is this just bravado, or is this man clinically insane?

Most of the attempts to psychoanalyze Bush from afar – Dr. Justin Frank’s 2004 book, Bush on the Couch, being the most noteworthy – have come away deeply troubled by this president’s ever-repeating pattern of refusing responsibility and projecting blame onto others. But to understand Bush’s psychological characteristics, it’s important to go barking up his family tree.

In generation after generation, the Bush family has been consistently marked by the same two behavioral patterns: a strange aggressiveness and a sort of stubborn emotional coldness, the latter being a truly breathtaking inability to confront pain, shame or any other inner turmoil.

In perhaps the greatest example of the Bush family malaise, George’s parents – Barbara and George H.W. – went golfing the day after the death of their second child, Robin. Barb and H.W. didn’t have a funeral for Robin, and never talked to George about the family loss, which would seem strange except that this inability to deal with death and grief was a family trait; Barbara had not attended her own mother’s funeral.

Given this, it’s not surprising that the Bush administration banned the filming of caskets of returning war dead from Iraq, or that Bush himself has yet to attend a dead soldier’s funeral. What Cindy Sheehan protested as let-them-eat-cake politics that proved Bush’s insensitivity to the families of wounded veterans might instead have just been family tradition, and evidence of Bush’s inability to confront human emotion.

As a father, George H.W. was absent all the time and not particularly interested in talking to his children. It’s this sensitive man who produced George W. Bush, who as a young man responded after reading The Grapes of Wrath at Harvard Business School with, “Look, people are poor because they’re lazy.” This from a man who would not hold a real job until he was nearly 40, keeping self-employed in an astonishing variety of tit patronage posts, including, most spectacularly, a job as a “pillow-toter” for Republican Senate candidate Edward Gurney. (Gurney had a war wound and hired W. to carry a pillow for him on the campaign trail.)

Bush entered office a man who, until his election to the governorship of Texas, had been a conspicuous failure at pretty much everything he’d ever tried, from school to business (where his indifferent management cost a number of companies millions in losses) to the armed services. Throughout his history, he appeared quite obviously to be an overgrown child who overcompensated for feelings of inferiority through misplaced braggadocio.

All of which makes it unsurprising that Bush as president would become known for denying his failures and blaming them on other people. Bush famously responded to a Jay Leno question about whether or not he’d ever done anything he was ashamed of by saying “I didn’t” before telling a story about his brother Marvin peeing on the family steam-iron.

No one can say for sure what it is that makes Bush so incapable of looking inward and admitting to his own mistakes. Frank posits that Bush was so ashamed of his natural first-child hostility to his sister Robin – feelings that he was not allowed to confront – that he grew up in a state of perpetual terror before his own anger and shame, and perhaps on some unconscious level still blames himself for her death. Frank and others have also noted that Bush as a recovered alcoholic has a natural fear of his own anxiety, given that any inner turmoil would naturally represent a threat to his sobriety.

Whatever the source of the problem, the fact is that George Bush was already a buck-passer and a blame-shifter even back when his biggest life “failures” were things like being a drunk, driving a car into a row of garbage cans in Dad’s driveway, and being perhaps the only grown man in the history of Texas to fail to make money selling oil.

Psychologists will tell you that it is typical for patients with profound unresolved conflicts to have grandiose delusions of omnipotence. George Bush is the same kind of reality-averse weakling – an overgrown child trapped in an endless cycle of arrested development and Oedipal defeat. But owing to an outrageous cultural accident, he has been physically propelled into the very throne that most delusional paranoiacs can only imagine for themselves.

Which makes one wonder what will happen when that throne is taken away from him on January 20, 2009. The White House, with all its vast power and influence, was Bush’s protection against the unimpressive reality lurking underneath.

Matt Taibbi is a writer for Rolling Stone magazine.