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  • That is an awkward question, but it's one that's being asked

  • on every major news network in America.

  • President Trump's fitness for office is now the top story in the country.

  • Reports suggest that even Trump's advisers are worried about it.

  • Everyone around the president questions his intelligence and fitness for office.

  • 100 percent of the people around him.

  • Concerns have gotten so bad that Trump agreed to be screened for dementia

  • as part of his last health exam.

  • None of this has to do with Trump's political positions.

  • They have to do with his ability to understand the world around him

  • and make good decisions.

  • Everybody wants to know: is this president of sound mind?

  • And if talking about this kind of thing makes you uncomfortable,

  • wait 'til you see how much it's stressing out actual mental health experts.

  • In a series of tweets, the president insisted that he is "like really smart" and a "very stable genius."

  • Last October, a group of 27 mental health experts

  • published this book: The Dangerous Case of Donald Trump.

  • In it, they warn that Trump's behavior shows him to be dangerously unstable,

  • describing him as a pathological narcissist who's delusional, suffers from paranoid ideation,

  • lacks conscience and empathy, and exhibits a host of destructive and dangerous psychiatric symptoms.

  • Yeah, it's rough.

  • Two months after its publishing, the book's editor met with 12 US senators

  • to talk about Trump's mental fitness.

  • That editor's name?

  • Dr. Bandy Lee.

  • I am a forensic psychiatrist at Yale School of Medicine

  • and an internationally recognized expert on violence.

  • Since the book came out, Dr. Lee has become kind of the face of mental health experts

  • warning about Trump.

  • We express our consensus view that

  • Some of the psychological signs are:

  • All of these are highly associated with violence.

  • One thing I noticed is that she starts almost every interview about Trump by saying

  • this: I'd like to make clear that I speak for myself

  • She did it in our interview too.

  • That's because what Dr. Lee and her colleagues are doing,

  • discussing the mental health of a politician who isn't their patient,

  • is pretty controversial.

  • And to understand why, we have to go back to 1964.

  • Don't tune out.

  • I'll make this quick.

  • Back then, Republican Sen. Barry Goldwater was running for president.

  • He was a far-right candidate who talked openly about wanting to use nuclear weapons

  • and was endorsed by the KKK.

  • I know, time is a flat circle.

  • In response to Goldwater's candidacy, Fact Magazine published this piece,

  • in which over 1,000 psychiatrists argued that he was psychologically unfit to be president.

  • Goldwater lost the election, but he sued the magazine's publisher for libel

  • and won, causing the magazine to shut down.

  • In response, the American Psychiatric Association created this guideline,

  • which states that when it comes to public figures,

  • it is unethical for psychiatrists to offer a professional opinion

  • unless they've conducted an examination on that person.

  • They called it: the Goldwater Rule.

  • Well, I was going to say it.

  • But yeah, the Goldwater Rule.

  • Which brings us back to this book.

  • Lee and her colleagues argue that they're not violating the Goldwater Rule because

  • We're not interested in making a diagnosis.

  • They're assessing how dangerous he might be based on his public behavior.

  • Most of the information that you get about dangerousness

  • comes from observation of their behavior, watching their interactions with people,

  • assessing them in real situations, reports of how they respond,

  • objective signs that we can still evaluate even if it's not enough to make a diagnosis.

  • But in March, the APA expanded the Goldwater Rule,

  • clarifying that rendering any professional opinion

  • about a public figure's affect, behavior, speech,

  • or other presentation is unethical.

  • In other words, unless Trump agrees to a full mental health screening

  • never going to happentons of psychiatrists are basically barred

  • from commenting on his mental health.

  • And that is very alarming to me.

  • Many people call it a gag rule.

  • Gag rule, I'm into it.

  • You would be.

  • That gag rule has a big impact on how the media

  • talks about Trump's mental fitness.

  • Lee worries that if they can't talk to mental health experts,

  • journalists are more likely to normalize Trump's abnormal behavior.

  • Most people are not used to seeing impaired individuals

  • day in and day out, so

  • It's tough to grapple with the possibility that

  • the person in charge of our nuclear arsenal might be deeply unstable.

  • So instead, our brains look for other explanations for Trump's behavior.

  • I want to believe he's just dishonest, not delusional.

  • Trump peddles conspiracy theories about Obama's birth certificate, and he's just playing

  • to his base.

  • Is there some strategy in bringing up the Obama birth certificate thing again?

  • Trump is not delusional.

  • He's being very politically savvy.

  • What should be evidence of a serious emergency gets downplayed as just Trump being Trump.

  • Donald Trump's a different type of guy.

  • I mean, he operates differently.

  • That difference has made him very successful.

  • One of Lee's colleagues has a great name for this phenomenon.

  • He calls it "malignant normality."

  • Ooh. I know.

  • It's a great drag name.

  • The result is that journalists end up missing big danger signs,

  • signs that mental health experts could catch.

  • Pundits will simply say, “That's just Trump being Trump,”

  • or, “It's tough talk.”

  • One crucial contribution that mental health professionals can make is to

  • But the bigger problem with the APA's gag order

  • is that it surrenders debates about Trump's mental fitness

  • to non-experts.

  • Isn't it remarkable that we're talking about the president's mental state?

  • To political commentators or partisan pundits who actually aren't qualified to talk about this.

  • I'm not a doctor, but I can tell you what I see and hear.

  • I'm not a doctor, but I can see that he is not the sharp mind that he was.

  • I'm not a doctor, but his behavior is erratic.

  • To me, that's classic narcissism.

  • I'm not a doctor but...

  • Leaving mental health issues to pundits, non-professionals,

  • can keep the public in the dark and keep them

  • confused.

  • These discussions can quickly become train wrecks,

  • where mental fitness is used as a weapon to smear political opponents.

  • So many of the traits of a sociopath this man is displaying.

  • I can't explain this crazy behavior, but I can call it crazy.

  • You saw it during the Obama years, when Fox News

  • regularly made wild accusations about Obama's mental state.

  • We all know that Obama is a narcissist, but this is bordering on the pathological.

  • He doesn't seem to have empathy or feelings for Americans.

  • He is certainly unfit to be president.

  • And Lee worries that this kind of coverage trivializes real concerns

  • about Trump's mental fitness, reducing them to

  • just another talking point for pundits to argue about.

  • As this conversation escalates, both sides sort of retreating to their corners.

  • The more that mental fitness sounds like a left-wing talking point,

  • the harder it is to take it seriously.

  • To now say, “Oh, well, look, he seems unhinged,” does seem like you're not willing to accept

  • the political reality that you are living with.

  • To accept that it is simply a political issue or a partisan issue

  • is an attempt to normalize the discourse.

  • No one's a doctor tonight that I've seen.

  • And somehow say, because you don't like what he said tonight in his speech,

  • that he's somehow unfit to be commander in chief,

  • that is the most ridiculous...

  • Whoa, whoa, whoa, everybody stop, stop.

  • The original goal of the Goldwater Rule was to help prevent mental health from being politicized.

  • But if the last few months have shown anything, it's that silencing mental health experts

  • does the opposite.

  • Politicization is almost inevitable without expert input.

  • Mental health expertise, just like medical expertise,

  • is neutral on all those grounds.

  • Trump has made questions about his mental fitness unavoidable.

  • What remains to be seen is whether actual experts

  • will be allowed to answer them.

That is an awkward question, but it's one that's being asked

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The awkward debate around Trump's mental fitness

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    Samuel posted on 2018/03/25
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