Mad King or Ad Lib?
The Weaponization of ‘Crazy’
By Seth D. Norrholm, Ph.D. and David M. Reiss, M.D.
Mental illness, whether called out directly in clinically-accepted terms or labeled with pop psychology jargon such as “insane,” “crazy,” or having “lost it,” is conveniently and often unnecessarily being thrown out as a defense or cause for unprecedented, alarming, norm-busting behavior on all sides of the political spectrum.
Volumes have been written about the mental health of the sitting President and his fitness for office. Whether skirting the Goldwater line or bulldozing straight through it, professionals and laypersons alike have described and labeled the malignantly narcissistic behavior of Donald J. Trump. Others have gone further to suggest that the President’s pathological narcissism is layered upon the behaviors of an aging, organically declining brain. We and others have suggested (and vigorously debated) whether or not Trump’s behavior represents “true” psychopathology, a persistent personality disorder, or the behavioral manifestations of an evil genius pretending to be “crazy.”
We argue now that no matter what the root cause or motivation, these behaviors are disqualifying regarding Trump’s ability to service as POTUS. This lack of fitness is not in any way ameliorated by suggesting, “No, he’s not crazy, he’s just acting crazy.”
The problematic and overtly dysfunctional, misleading, and irresponsible publicly observable behavioral patterns are not unique to the President. Rudy Giuliani, the former prosecutor-turned Mayor of New York City-turned Trump’s “unpaid personal lawyer”, is a common fixture on cable news networks (with a familiar proclivity towards Fox News).
What makes Giuliani’s appearances so remarkable is that he “acts crazy.” From an observational, diagnostic viewpoint, Rudy shows signs that are consistent with delusions, grandiosity, mania, borderline personality traits, and related psychotic expressions. However, the question remains unanswered, is Giuliani pathological or impersonating psychopathology, effectively a reincarnation of Andy Kauffman? Hell, Giuliani just claimed his mission was to “disrupt the world.” We argue, just as we now would with Trump, that it no longer matters. Pure psychiatric illness versus the portrayal of psychiatric illness (whether believable or not) are both disqualifying and fundamentally dangerous.
Using mania as an example, we tell our students that clinical mania presents like a firehose that one is futilely trying to hold back (the water being pressured thoughts, ideas, plans, or speech). Right now, Giuliani is a firehose loose in the streets of cable news spraying everywhere. He is out of control and a convenient distraction. Ukraine-gate has conveniently pushed Sharpie-gate out of the collective conscience after Sharpie-gate pushed Epstein-gate out of the news. Whether an act or not, Giuliani’s “public crazy” is serving a purpose.
Why would Presidential cast members (or court jesters) act crazy in defense of a former reality TV show host already named as a co-conspirator in an illegal hush money scheme who has also admitted on national TV that he obstructed justice (see Lester Holt interview) and has broken more campaign finance/bribery/emoluments laws? One possibility is that for public figures or celebrities, irrelevance is a fate worse than death.
Did “America’s mayor” jump on the Trump train to cling to relevance?
Did William Barr come out of retirement to serve as a consigliere for Trump to reclaim a public presence?
Do Jim Jordan and Devin Nunes see their only chance at keeping meaning and relevance (by their definitions) in clinging to a sinking GOP?
The latter is one possibility and as we have discussed elsewhere, there are cult-specific psychological mechanisms that also may be at play (above and beyond practical circumstances and pressures, such as re-election, knowledge of kompromat vulnerability, licit or illicit financial gain, etc.)
For years now, mental health professionals have been handcuffed by the Goldwater Rule, an American Psychiatric Association edict stemming from public “diagnosis” of presidential candidate Barry Goldwater in the 1960’s; a rule that prevents one from making a diagnosis without examining the individual in question firsthand. Many have argued that this is an antiquated idea and increasingly irrelevant in the present time with thousands of behavioral data points available across platforms — much more than can be gleaned from an in-office psychiatric interview.
Further, the Goldwater Rule was adopted in response to an article in “Fact” magazine that included psychoanalytic conjecture about Goldwater’s unconscious motivations as well as rather wild speculation regarding specific “Axis I” mental illnesses — all of which is very different from commenting, from the point of view of a mental health professional, upon the significance of indisputable, publicly-observed dysfunctional behaviors.
What is also striking is that while there has been hesitance and suppression of mental health discussions of Trump and his cohorts on many fronts, mental health and illness have been weaponized by the current President, his sycophants, and the complicit GOP. Greta Thunberg, a 16-year old climate activist was labeled mentally ill (an attack that was later softened). The perpetrators of mass shootings have been mischaracterized as “mentally unstable” which lies in stark contrast to the empirical evidence on mental health and gun violence. The President himself has called numerous critics and perceived enemies as “nut jobs,” a “sick guy/man,” “wacky,” or a “crazed lunatic.”
As mental health professionals, we hope that we have helped the public, the political establishment and the media to understand the probable implications of publicly-observed dysfunctional behaviors; implications regarding likely future behaviors, commitment to ethics and decency, ability to comprehend complex issues, ability to exercise of sound judgment and the competence to develop and implement appropriate and effective public policy.
However, it is neither required nor necessary to consult with any mental health professional to be able to conclude, with an extremely high level of confidence, that the bizarre, grandiose, mendacious, bellicose, and inconsistent behaviors repetitively displayed in public by Trump and his cohorts (remember Giuliani is not a member of the Administration) disqualifies each and every one of those individuals, from Trump down, from serving in public/political office/capacity — and provides ample justification for their removal from those positions.
About the Authors:
Seth D. Norrholm, PhD (Twitter: @SethN12) is a former Associate Professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine. Dr. Norrholm has spent 20 years studying trauma-, stressor-, anxiety-, depressive-, and substance use-related disorders and has published over 95 peer-reviewed research articles and book chapters. The primary objective of his work is to develop “bench-to-bedside” clinical research methods to inform therapeutic interventions for fear and anxiety-related disorders and how they relate to human factors such as personality, genetics, and environmental influences. Dr. Norrholm has been featured on NBC, ABC, PBS, CNN.com, Politico.com, Salon.com, The Huffington Post, Yahoo.com, USA Today, WebMD, The History Channel, and Scientific American.
David M. Reiss, M.D. (Twitter: @DMRDynamics) has been a practicing psychiatrist for more than 30 years, specializing in “front-line” adult and adolescent psychiatry. He has evaluated and treated over 12,000 persons of diverse social and cultural backgrounds, from every occupational field. Dr. Reiss has been recognized internationally for expertise in character and personality dynamics. He is often interviewed and quoted in the print, Internet and radio/TV media, nationally and internationally, to help the public understand the psychological aspects of current events. Dr. Reiss was a co-author on the New York Times bestselling book, “The Dangerous Case of Donald Trump.” He is an authority on issues regarding social and political phenomena, medical and mental health treatment, PTSD, violence in society, and the functioning of the current mental health system.
