Stop Calling Trump “Crazy”: It’s Stigmatizing and Oppressive
At times of social and political upheaval, it is important that psychologists and other experts practice more ethically, not less. In a time of unprecedented political attacks on scientific evidence and inquiry, it is more important than ever that we aim to align with evidence-based practices, our ethics codes and the responsibility of disseminating accurate information. By compromising ethics, we can become dangerously hypocritical and oppressive, and further stigmatize mental illness.
In an article published on January 28, 2017, author Zach Cartwright shares a clinical perspective from Dr. John D. Gartner, a psychologist who teaches at Johns Hopkins University. As is outlined in the article itself, it is unethical for Dr. Gartner to offer a diagnosis of an individual he has not assessed himself and without that individual’s consent. In a time where many are trying to make sense of a president seemingly acting impulsively and irrationally, it can be appealing to look for any means of validation of what many have long suspected: President Donald Trump is mentally and emotionally unhinged and is a danger to our country.
However, offering a diagnosis in such an unethical manner parallels what is occurring in government leadership at this very moment: a definitive conclusion offered on a lack of sufficient evidence. Furthermore, it does so at the expense of millions of individuals labeled as mentally ill. Discrediting President Trump by associating him with a psychiatric diagnosis does nothing more than play upon the stigmatized fears people hold related to mental illness. In the end, leaning into such stigma is unlikely to have a significant impact on Trump, but undeniably is detrimental those who suffer daily from this stigma and are not protected by the privileges of race, class, gender, and power.
It is true that there are demonstrated hallmarks of personality disorders that Trump meets in his public behavior — many of which Dr. Gartner points to in formulating his diagnostic impression. However, these behaviors stand on their own, and do not require the distraction of classification. The purpose of psychiatric diagnosis must be held firmly to the principles of beneficence and nonmaleficence — to benefit the diagnosed, not harm them. Such a public shift towards the use of diagnostics to harm, stigmatize, dismiss, and discredit another betrays the responsibility to protect civil and human rights through professional and scientific work. This shifts the argument against Trump towards individual characteristics and away from important conversations about the dangerousness and real world impact of his behavior and policies.
Ultimately, offering a diagnosis of Trump minimizes these issues to an individual level, one in which all blame is directed to a sole individual. It should be clear at this point that Trump presents with attitudes and behaviors that are shared by many other individuals (individuals who are now starting to identify themselves more overtly) in this country and around the world — likely more than the prevalence rate of just 0–6.2% of community samples presenting with Narcissistic Personality Disorder (Dhawan, Kunik, Oldham, & Cloverdale, 2010).
Furthermore, it is important to remember that “crazy” is not an umbrella term for behavior and attitudes that is immoral, unethical, or irrational. If we continue to operate in a manner that assumes this to be an individual problem, efforts of advocacy will not gain momentum as we will never address the multiple sources of the issue. It is more important to recognize that privilege — grounded in race, gender, class, religion, and sexual orientation, among others — has fueled hate, discrimination, and xenophobia; the shift to a conversation about mental fitness only distracts us from these real issues.
Finally, there is a clear risk of conducting diagnostic assessment at a distance. At this time, we cannot afford to remove the safeguards that are in place to prevent the misuse of psychiatric diagnoses. Important provisions that call for the demonstration of significant distress or disability in social, occupational, or other important activities necessitate the client to have a voice in their assessment — a voice pivotal to preventing the misuse of the field of psychology for oppressive means. We cannot forget our history in the field of mental health and the misuse of the stigma of mental illness to control dissent under oppressive regimes. Dr. Gartner legitimizing the use of diagnostics (without adhering to outlined ethical principles) as a way to discredit opposition, no matter how distasteful the opposition is, sets a dangerous and frightening precedent that we cannot let stand.