David Davidson-Methot: Trump a danger to the US, world
There is much talk in the popular press about President Trump’s mental state, or mental fitness for the presidency.
While most was spurred by the recent release of Michael Wolff’s book about the inner workings of the Trump White House, “Fire and Fury,” a discussion among mental health professionals began much earlier.
In April of last year there was a meeting of such professionals at Yale University, and a subsequent book, edited by Yale Medical School faculty member, Dr. Bandy Lee, called “The Dangerous Case of Donald Trump,” (2017, St. Martin Press, NY) which contains articles by 27 different writers, mostly esteemed mental health experts such as Dr. Philip Zimbardo (retired professor at Stanford) and Dr. Robert Lifton (professor at Columbia), to name only a few. I have read this book, and several of the recent articles, including publications online and in print from CNN (Serfaty & Nobles, 1/5/18), the New York Times (Barnes & Haberman, 1/5/18) and the Sacramento Bee (Rhee, 1/8/18; Witcover, 1/9/18).
As a practicing psychologist myself, I am both intrigued and alarmed. I agree with Dr. Allen Frances (Duke University School of Medicine, quoted in New York Times article that many of those sharing opinions are “amateurs” who “don’t know what they’re talking about.” Many are too loose with terms they likely don’t fully understand, such as “crazy” or “dementia” or even “mental illness.” However, Dr. Frances also goes on to opine about Mr. Trump, “He is definitely unstable … He is definitely impulsive. He is world-class narcissistic not just for our day but for the ages. You can’t say enough about how incompetent and unqualified he is to be leader of the free world. But that does not make him mentally ill.”
I may disagree with Dr. Frances on that last point, since a “personality disorder,” according to the Diagnostic and Statistical Manual of Mental Disorders (of which Dr. Frances was a co-author) is, in fact, a diagnosable mental illness, of a particular category or type. But that is not really the most pertinent question anyway.
Perhaps many of my other colleagues are correct. The focus is not whether or not the president is mentally ill, but whether or not he has the mental capability to responsibly exercise the awesome power of his office. This is the question raised by Dr. Lee and her/my colleagues. The issue is not the presence or absence of illness, but of dangerousness. One who so lightly compares his “red button” to that of the despot of another authoritarian nuclear armed country may simply be characterologically unfit for the office, and the 25th Amendment offers a solution to a potentially world ending problem.
Dr. Lee appeared before members of Congress last month and made precisely this argument (as reported by CNN), that she is not necessarily violating the American Psychiatric Association’s “Goldwater Rule,” which forbids psychiatrists from diagnosing public figures that they have not personally assessed, but that assessing “dangerousness” is a lower standard, and one which mental health professionals also have an ethical obligation to observe.
In California, for example, while we have strict laws protecting patient confidentiality, we also have the “Tarasoff rule,” which resulted from a court ruling following a tragic incident, which expressly commands mental health professionals to break that confidentiality in cases where a patient makes a credible threat of harm to another person.
Additionally, we are commanded to break confidentiality in situations in which, during the course of therapy, the clinician learns of child or elder abuse. In such instances the clinician has an ethical and legal “duty to warn” of the current or impending danger in order to protect the safety of victims.
Dr. Lee, and many of my colleagues, believe that Mr. Trump presents just such an immanent danger, a credible threat to the safety not just of our country but, given his access to his “bigger and more dangerous” red button, to the human race and the whole world.
I confess to sharing my colleagues’ concern.
David Davidson-Methot, PhD lives in Grass Valley.
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