In a very recent publication entitled, The Dangerous Case of Donald Trump (2017), (Lee, Bandy, M.D., M. Div., Organizer of the “Yale “Duty to Warn, Conference”) , a smattering of psychiatrists, psychologists, and mental health professionals, although bound by the Goldwater Rule, in Section 7.3 of the APA code of ethics (Psychiatric Association, 2013, p. 6) which states, “It is unethical for a psychiatrist to offer a professional opinion [on a public figure] unless he or she has conducted an examination and has been granted proper authorization for such a statement,” broke ethical silence. This ethic further, “Highlights the boundries of practice, helps to preserve professional integrity, and protects public figures from defamation.”
In a conference held on April 20th, 2017 at Yale University, the mental health professionals found enough wiggle room to offer quasi-diagnostic opinions and observations regarding US President Donald Trump. They agree with and adhere to the Goldwater Rule but also believe that when national security is at stake, they have a duty to warn the public regarding outrageous behavior, irrespective of what position someone holds. The issue of presidential acumen was catapulted into the American consciousness in 1964 when Fact published an article, “The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater.” The magazine polled 12,356 psychiatrists about American Senator Barry Goldwater with one simple question: “Do you believe Barry Goldwater is psychologically fit to serve as President of the United States?” The editor, Ralph Ginzburg, was sued for libel in Goldwater v. Ginzburg where Goldwater won $75,000 (approximately $579,000 today) in damages.
Under scrutiny and potential attack by the political right, mental health professionals who convened for the Yale Conference took a courageous stance in order to protect the public trust from what they perceive to be dangerousness—a concept that lacks diagnostic criteria. The compendium of expertise in the book is quite insightful and revealing; yet, what some may perceive as very derogatory towards the nation’s leader. Authors believe the world is in trouble as someone labelled “Crazy like a Fox,” may be “Crazy like a Crazy.” The reality is that the current president has access to a button that could lead us into a disastrous nuclear war. Contributors to the book believe the nation’s security trumps Donald Trump.
In the compendium, 27 professionals analyzed numerous Trump’s twitter quotes open to public scrutiny, derogatory statements about groups made in public, and historical analyses taken from The New York Times (Horowitz, 2016) and The Guardian (Dean, 2016) placing them under the microscope and came up with some very insightful, yet critical, diagnostics. Hedonism, narcissism, misogyny, paranoia, overt self-aggrandizement, and racism are but a few labels that professionals use in the book to analyze Trump as he sits in what is considered ostensibly to be the most powerful position in the world. Standing on the shoulders of people like Eric Fromm, Otto Kernberg, and Sigmund Freud to substantiate their quasi-clinical observations—and although I am not a great fan of Sigmund Freud, he did conceptualize some very interesting pathological dimensions of the human mind—one of which he termed the narcissistic personality—this group of analysts shared their observations. Some of the characteristics of the narcissist include but are not limited to anyone that believes himself or herself to be better than others; fantasizes about power, success, and attractiveness; expects constant praise; and believes others are jealous of you are but a few features that constitute the narcissistic personality.
The analysts argue that narcissism can be placed on a continuum from healthy on one end to unhealthy on the other end. Far beyond the continuum is narcissistic extremism— something that distinguishes Trump from other types referred to as malignant narcissism. Famed psychoanalyst Erich Fromm coined this term, which “is not a diagnosis.” Personality disorder expert Otto Kernberg used this term in describing historical figures like, “Adolf Hitler, who murdered millions, Kim Jon-un, who’s suspected of ordering his uncle’s and brother-in-law’s deaths and Vladimir Putin, who jokes about “liquidating journalists.” According to the experts, it is lucky for Americans that “not all malignant narcissists are overtly dangerous like Hitler, Putin, or Kim Jon-un.” Is Trump a danger to self or others? We should probably not push him into a corner to find out.
Authors wonder why Trump has developed an attraction for dictators—perhaps, an unconscious desire to emulate them. He has publicly threatened at least one leader that he believes threatens the security of the United States, with a sense of grandiosity that garners the attention of many. Can this be construed as an abuse of power; that is, making a threat without a willingness to talk, negotiate, and find common ground to keep peace? Or is it an act of aggression that will catapult Trump into the role of the hero with the many delusional and racist fans that support him?
There have been other presidents that crossed ethical lines but none so nonchalantly as Trump. Richard Millhouse Nixon lied but was caught and pushed the envelope about as far as I would like to see it pushed. The fiasco during the Watergate scandal is proof of his imbalanced mind. Trump has gotten caught with his hands in the cookie jar many times and lies more to cover his first line of untruths. His racist attacks against People of Color, women, and the disabled are just a few of the groups that he abhors openly.
As a past mental health professional for 17 years, I support the courage displayed by the many psychiatrists, psychologists and mental health professionals that decided to practice ethics that are part of what América is supposed to stand for. By the way, it is not unethical to warn people of potential danger.
Dr. Ramón Del Castillo is an Independent Journalist. © 11-21-2017 Ramón Del Castillo.
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