Mary Trump: Psychiatrists Know What’s Wrong with My Uncle - Voters Need to Know

Donald Trump's niece, Mary Trump, has an op-ed in the Washington Post that looks at the ridiculous stance of the American Psychological Association - the so-called Goldwater Rule -  that bars mental health experts from speaking out on the obvious mental health problems of the current occupant of the White House and other politicians who routinely impact the lives of hundreds of thousands, if not millions of citizens.   With hours and hours of video of Donald Trump - a/k/a Der Trumpenfuhrer - deranged and self-absorbed behavior and interviews, Mary Trump makes the case that mental health experts should be free to speak their opinions and warn Americans about a truly deranged and dangerous individual. Her position reminds me of our friend Ralph Northam's statement to the Washington Post about Trump's mental illness when Northam reminded the reporter that Northam is a neurologists and does know about mental illness.  Here are highlights from Mary Trump's column:

In 1964, Fact magazine published an unscientific survey asking psychiatrists whether they thought the Republican nominee, Barry Goldwater, was psychologically fit to serve as president of the United States. The problem wasn’t that professionals felt the need to share their views of what they considered Goldwater’s dangerous ideas; it was the irresponsible and often bizarre analyses that were in some cases based entirely on rank speculation.

Embarrassed, the American Psychiatric Association (APA), in reaction to this debacle, established the “Goldwater Rule,” which barred its members from diagnosing public figures. It concluded that “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.” That’s fair, as far as it goes. But in March 2017, shortly after my uncle, Donald Trump, was inaugurated, the APA didn’t just reaffirm the rule — it expanded it past the point of coherence. Not only were members prohibited from diagnosing public figures, now they could no longer offer a professional opinion of any sort, no matter how well supported or evidence-based, even if they believed that a public figure posed a threat to the country’s citizens or national security.

This is absurd on its face and has potentially serious consequences for the safety of the American people. While psychiatric diagnosis is a technical process, it is entirely within bounds to draw conclusions based on observable behavior. It is one thing to declare definitively that a person has anti-social personality disorder (a specific diagnostic term); it is another to point to behaviors — such as deliberately putting other people in harm’s way for no discernible reason (for example, abandoning our Kurdish allies) beyond one’s own self-interest — and express the general conclusion that it is dangerous to have somebody in the Oval Office who is incapable of empathy.

It is not an exaggeration to say that Donald has exhibited pathological behavior that is equally alarming — as evidenced most recently by his callous disregard for his own health and the well-being of those around him when he left Walter Reed hospital while still shedding coronavirus, or when he holds rallies and encourages thousands of people to attend without wearing masks or social distancing in order to prop up his ego.

Every day legal experts weigh in on Donald’s unconstitutional or norm-breaking behaviors. Since his covid-19 diagnosis, medical experts have speculated about the course of his illness and the potentially dangerous side effects he may be experiencing as a result of the experimental treatments he’s received. Only the mental health experts have been effectively sidelined.

If we look at the past 3½ years, Donald has lied publicly in excess of 20,000 times; he has impulsively, and against all reason, gone against the advice of experts who could have helped contain the pandemic and protect the economy; he has put private citizens at risk by attacking them on Twitter because they have criticized him; he has proved himself to be incapable of accepting responsibility, changing course or exhibiting empathy.

I am a trained clinical psychologist and have worked as a clinician. If Donald had walked into my office for an evaluation, I would have gathered less information about him from a normal intake interview than I could gather from the countless hours of video available from his decades in the public eye. Usually when self-reports aren’t available — because the patient is either unable or unwilling to offer information — the clinician often turns to those close to the patient in order to fill in the blanks. But none of that is necessary because examples of Donald’s disordered, impulsive, self-defeating and destructive behavior, which are unlikely to present themselves in a clinical setting, have been extensively recorded.

Adopting a notionally neutral stance in this case doesn’t just create a void where professional expertise should be — it serves to normalize dysfunctional behavior. Paradoxically, the suggestion seems to be that speaking out about mental illness is the problem. But in truth, it is remaining silent about Donald’s obvious psychological impairment that is stigmatizing. By claiming that its silence is neutral, the APA is essentially granting Donald’s campaign an in-kind contribution while the American people remain subject to his often deranged and unpredictable behavior, without the tools necessary to evaluate it or understand how it renders him unfit for the office he holds.

I agree with Mary Trump.  The APA is doing American citizens a severe disservice.