The Mental Health Debate

Recent articles in the New York Times have advanced the question of Trumps’ mental health status, and the threat it poses to the country. This is connected to a larger issue: Is it possible to declare the President unfit to serve based on a mental health diagnosis?

On February 13, 2017, a group of 33 psychiatrists and mental health experts wrote in a letter to the New Work Times:

Silence from the country’s mental health organizations has been due to a self-imposed dictum about evaluating public figures (the American Psychiatric Association’s 1973 Goldwater Rule). 1 But this silence has resulted in a failure to lend our expertise to worried journalists and members of Congress at this critical time. We fear that too much is at stake to be silent any longer.

Mr. Trump’s speech and actions demonstrate an inability to tolerate views different from his own, leading to rage reactions. His words and behavior suggest a profound inability to empathize. Individuals with these traits distort reality to suit their psychological state, attacking facts and those who convey them (journalists, scientists).

In a powerful leader, these attacks are likely to increase, as his personal myth of greatness appears to be confirmed. We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president.

The Chairman of the task force that wrote the Manual for Mentsal Disorders (DSM4), Allen Frances, responded with a letter of his own, in which he objected to the diagnosis, but stated:

Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption, and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither).

Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers.

His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.

Some people are beginning to ask for a psychiatric evaluation of the President. Based on such a diagnosis, the cabinet has the constitutional power to remove him from office with a simple majority vote. The criteria for “narcissistic personality disorder”  are well-established, and watching the President’s repetitive and exhausting pattern of self-aggrandizement, need for admiration, vulnerability towards criticism, and lack of empathy for others, begs for a laymen’s diagnosis. His anger is theatrical, but his attention deficit problem is real and severe. He revels in the act of speaking without saying anything, and he hates a critical audience (the press.)  If it were not the President of the United States, most of us would have lost interest by now. His repetitiveness is nauseating.

He poses multiple threats to the security of the United States:

  • He could be a puppet of the Russian Government, based on secret sex tapes from a visit to Moscow in 2013.
  • He may take military actions against potential enemies without good judgment and advice. It is extremely worrisome that this man has almost exclusive powers to make decisions about nuclear strikes.
  • He opens the door to fascist tendencies in the US and all over the world.

Looming Threat of Fascism?

After his first disastrous month in office, the Trump effect on American politics is becoming more clear.

  • There is a purposeful unwillingness to separate truth from lies. Trump has a theme: The press, as a whole, is an “enemy of the American people,2 He usurps the traditionally left-wing concept of “ideology” and turns it against American news outlets by accusing them of systematically producing “fake news.”
  • Trump inflames growing resentment towards immigrants, refugees, and minority groups. He especially targets Muslims, repeating the phrase that we are under attack by “radical Islam.” This worldview evokes the memories of the crusades and seems to be an implicit call for stronger responses from the police and the military.
  • Trump feeds on a movement where people are calling for strong leaders. They are flirting with authoritarianism and romanticize it in times of deep uncertainty. Institutionalized forms of politics that advance values like freedom and democracy through principled actions and complex negotiations, suddenly seem insufficient: This is the political order Trump supporters want to overthrow, without thinking much about the consequences, or about the historical analogies.

The Holocaust Museum in Washington recently posted a checklist of early warning signs of fascism. The poster was shared on social media like a wildfire. Here are the criteria they list:

  • Powerful and continuing nationalism,
  • Disdain for human rights,
  • Identification of enemies as a unifying cause,
  • Supremacy of the military,
  • Rampant sexism,
  • Controlled mass media,
  • Obsession with national security,
  • Religion and government intertwined,
  • Corporate power protected,
  • Labor power suppressed,
  • Disdain for intellectuals and the arts,
  • Obsession with crime and punishment,
  • Rampant cronyism and corruption,
  • Fraudulent elections.

Trump’s right-wing politics resonates with at least 8 of these 14 criteria. The attacks on journalists and the freedom of the press should be alarming to every citizen. Authoritarian regimes and dictatorships always start in this fashion. In addition, the American system of checks and balances is now experiencing a severe stress test. Will the courts stand up to outrageous actions in the name of executive power? Will the judges stand strong in the face of open intimidation? Will the Republican majority in Congress find its moral backbone and stand up to a President who lies, shows moral indifference, and disregards the separation of powers?

Resisting the Trump Agenda

Demonstrations alone will not suffice to stop the Trump agenda. Former congressional staffers have put together a program that lists the best practices for making Congress listen. Go to indivisibleguide.com to get organized and help defeat the looming dangers.

Notes:

  1. “On occasion, psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.” American Psychological Association, Ethics Code, section 7.3
  2. even Fox News took offense against this statement.

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