In Defense of Diagnosing Trump
Vox just posted a piece about how public ‘diagnoses’ of Trump’s mental illness are sloppy and hurt both the public understanding of psychiatry and our politics. I vey much disagree with this article. Let me explain why each central claim is wrong.
“Airmchair psychiatry undermines the scientific legitimacy of psychiatry.”
Mistake #1: This mistakes non-exhaustive analysis for inconclusive analysis.
The sort of behavioral ‘evidence’ we have on Trump is not worth nothing. It’s not the same as a structured diagnostic test. But this sort of ‘data’ is precisely the same sort of data that would be part of by a professional diagnosis of Trump. And such data, in some cases, may be conclusive. I‘d argue that we have all the evidence we need in order to diagnose Trump as a sociopath with narcissistic personality disorder.
Mistake #2: This assumes that psychiatry is a science ‘just like’ other sciences.
It’s a mistake to portray psychiatry as a rigorous science in the same vein as cancer treatment. You can’t do cancer treatment from the couch, but the sorts of things psychiatrists do can be done from the couch. This doesn’t mean psychiatry is bunk. It’s just not exactly like other sorts of medical disciplines. And we understand much less well the underlying conditions that psychiatry sudies. It’s just plain wrong to portray the psychiatric diagnostic tests as equivalent to the diagnostic tests for othe medical conditions — the structure of these tests and how to interpret their results are highly contested. We should be able to hold two thoughts in our head at the same time: mental health is a real thing, but it’s very different in nature from other health issues.
“Hallmarks of any mental disorder include dysfunction and suffering.”
Mistake #3: This makes it seem like all or most people with a mental health condition don’t have their lives together, and that isn’t true.
What’s ‘disordered’ is one’s thought patterns/mental functioning. And plenty of people with mental health ‘conditions’ are both a) not aware of their own ‘disorders’, and b) lead otherwise normal lives.
It’s also harmful to suggest that “you must not be suffing from any mental health problems because you’re doing fine”. Plenty of people who are outwardly successful nevertheless struggle with mental health problems. And we shouldn’t make these people feel as though their problems aren’t real.
“Efforts to label Trump with a mental disorder let our political culture off the hook.”
Mistake #4: Trump’s mental condition is not irrelevant to political analysis.
If we want to try to understand Trump’s appeal, it’s not irrelevant what sort of psychological traits he displays. We’re unlikely to succeed in understanding Trumpism if we don’t allow ourselves to recognize someone who is pathologically incapable of self-criticism. This is likely part of his appeal.
Mistake #5: It’s not unimportant for voters to know whether Trump really is a narcissistic sociopath.
We’re electing the President of the United States. If one of our candidates likely suffers from sociopathy and narcissim, that’s something I want to know about as a voter.
Mistake #6: diagnosing Trump does not preclude other analyses.
We can do two things at once: analyze Trump’s psyche, and analyze the abstract politics of Trumpism. These are not mutually exclusive.
