Earlier this month I posted a podcast I recorded with the only living member of the American Psychiatric Association ethics committee repsonsible for having written the so-called Goldwater Rule that some psychiatrists believe prevents them from speaking out about what they see is POTUS45’s defective mental state.
In the interview, Dr. Allen Dyer and I discuss how focusing on whether or not the president could be diagnosed with narcissism misses the opportunity to have a bigger, more important discussion about what we are saying about our collective mental state by having this man as president.
It caused a little stir.
Here is a link to what is, in a sense, a rebuttal to my discussion with Dr. Dyer, although read it carefully, because it might also seem as though the author, Paula Caplan, PhD, a clinical and research psychologist from Harvard University, agrees that the question of narcissism in POTUS45 is beside the point compared to the question of why at least a third of our country believes we need such a leader.
That is not quite the case. Dr. Caplan suggests in her Huffington Post piece, and in an email to me directly, that the question of narcissism should be irrelevant because it’s a made up diagnosis altogether, and because there is a more accurate way to gauge a president’s fitness for office: a history of past recklessness or dangerous behavior (all added emphasis is Dr. Caplan’s):
Dr. Jim Gilligan, who is one of the rare, responsible psychiatrists with decades of expertise about dangerousness, says that the point is not whether Trump has a mental illness but that he is dangerous, and that is not based on speculations, quibbles about which category of psychiatric disorder best describes him, or professional elitism (i.e., “We are therapists and therefore in a better position to evaluate Trump than are other people”…when it is obvious that he is dangerous, and that is the point, and there are major problems involved in calling Trump mentally ill) but on what Trump is known to have done that has been dangerous…
Dr. Caplan also stated in the email:
…to point out some indisputable facts that have DIRECT impact on the requirements of the job is both a safer and more relevant way to argue. Thus, his proven lack of information about various crucial nations, governments, and issues lead him to have no grasp of the consequences of his decisions/announcements of policy, etc., and this combines with his demonstrated criminal (sexual assault, racial discrimination in housing, failing to pay employees, having people threatened with harm, to name a few examples) and dangerous conduct to render him unfit for office. That is why it’s far better to cite Dr. James Gilligan re his comments on what is proven to be the best predictor and indeed only predictor of dangerousness — past dangerous behavior …
Neither creating a back and forth between psychiatrists and psychologists, nor whipping up feuds between individuals is my goal. I hold no animosity toward the profession. Further, the Diagnostic and Statistical Manual of Mental Diagnosis-5 (DSM5) Mood Disorder Task Force head, Jan Fawcett, MD, is a former mentor of mine to whom I owe much for teaching me about the field when we worked together as the medical and managing editor respectively of a psychiatric journal.
However, I do think it’s important to present Dr. Caplan’s perspective because she was a member of the task force that created the fourth the DSM-IV, and decided to resign from it for reasons she states in her HuffPo piece. Her point of view is informed and helps remind readers, as I did last week with my piece on the FDA, that conventional wisdom is often received, not vetted, which means it’s important — and necessary — to question the status quo.
In fact, there is a piece out on STAT+ today about this kind of pressure in medicine to not question the prevailing wisdom because someone might lose face — and funding. In this deeply reported piece about what happened when some in the Alzheimer’s research field tried to pursue lines of research not sanctified by the “cabal” as STAT’s executive editor, Rick Berke, put it, it’s possible we have lost many precious years of progress we otherwise might have gained in the search for a cure.
I agree with aspects of both Dr. Dyer’s and Dr. Caplan’s respective positions: we need to navel gaze about this as a nation, and there is plenty of evidence the president has a history of dangerous behavior (note: this is not a clinical term), the kind cited above by Dr. Caplan, for us to consider when evaluating his fitness for office.
There are many avenues one could take to demonstrate a history of past dangerousness, but this Washington Times report back in 2016 in the run-up to the election, when proponents promised this was all theater — namely, the encouragement of beating up dissenters at his rallies — and things would change once the man was given the nuclear codes.
Or, you can read this McSweeney’s timeline.
Per sexual assault claims, here is a piece in The Hill published earlier this week. It isn’t the accusation of rape that I want to point out; it’s the president’s specific way of denying it that I find dangerous in its cruelty: “I’ll say it with great respect: Number one, she’s not my type. Number two, it never happened. It never happened, OK?”
The first part of his response needs no decoding of its cruelty (I sure as heck hope it doesn’t!), but it is useful to point out that the second part is classic bully-speak, and is devoid of any empathy.
Per his lack of crucial knowledge about nations and foreign relations, again a report from The Hill, although I also was listening to the president in a BBC feed when I heard him misspeak: he named the wrong man, a dead man, a man who died in 1989, when he justified his reasons for increased sanctions against Iran.
I admit that Ayatollah Ruhollah Khomeini and Ayatollah Ali Khamenei are awfully close both phonetically and in spelling. And yet.
Getting words wrong when they sound similar is one thing. Getting them wrong when it’s critical to your job and when you are ratcheting up a potential military conflict is another. And while I wouldn’t say this is willfully dangerous behavior (it’s more of a cognitive issue, most likely), the consequences are potentially dangerous and it does bring in to question his fitness.
And then there is this, which I barely bring myself to write about. By this, I mean the squalid conditions of the holding pens for migrant children at the border. Say whatever you’d like about the need to protect, relax, close, open the border, I can see no strategic benefit to any argument that involves cruelty to children.
Yet it has been the president’s policy to treat these human beings — who had no choice in whether they were brought here — in such a way that a pediatrician who observed the children at a facility in McAllen, Tex., said, “It just felt, you know, lawless. I mean, imagine your own children there. I can’t imagine my child being there and not being broken.”
Those are just this week’s headlines to do with the president’s behavior.
It’s only Wednesday.
Which brings us back to where we started last week with Dr. Dyer’s podcast: why is this okay with us and what does it say about who we think of ourselves to be as a people?
Originally published at https://documental.substack.com.