What happens to a country and the world at large when their leader, possessed of immense social, political, economic and military power (i.e. enormous nuclear arsenal as well as conventional forces), may be dangerously mentally ill? (So much for starting off 2018 on a positive note, right?) What happens when, in this same situation, mental health experts are not allowed to diagnose a figure from afar and that our political system is additionally made vulnerable due to a lack of "intellectual or cognitive standards for being president" (Lee, 2017, p. 16-17)? This is the central dilemma around which law professor and practicing psychiatrist Bandy Lee's 2017 collaborative publication The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President focuses most of its energy.
Before going further, I wish to clarify a few terms introduced above. In the mental health profession, there is a rule that constrains these professionals from diagnosing a political figure that has not been consensually subjected to the normal psychological evaluation procedures. Termed the "Goldwater rule," it is meant to both protect these professions from ethical vulnerabilities stemming from the potential for professionals to damage the public credibility of mental health experts as a whole by misusing their expertise for various reasons, such as nefarious political manipulations (Lee, 2017, p. 17). Moreover, the Constitution remains silent on any mental health standards for a prospective president in the spirit of keeping the eligible pool of citizens as broad as possible, key to a democratic society striving to be as representative as possible while respecting an individual's boundaries and rights. The only case in which mental health professionals can detain a person against their will in the United States (in violation of their individual rights) is if that individual demonstrates a considerable danger to themselves or others due to mental illness. This legal authority vested in these professionals is used fairly often in the general population in conjunction with the criminal justice system, but requires a high burden of proof as a safeguard against abuse.
The 27 contributors to this volume seek to prove the dangerousness of our current president by drawing from indirect data about both the president and his administration from news reports, press releases, interviews, books and the like and speaking as concerned citizens with certain expertise versus concerned professionals (which would potentially put them at risk of violating the Goldwater rule). Their case is composed of three parts: the first on Trump himself, the second on the ethical dilemmas surrounding the Goldwater rule, and the third on the effects of Trump's potential mental illness on the populace. If not convincing all of its readership of the need to at least submit the president and vice president to annual mental health screenings at the request of Congress, the volume at least makes a very good case with what it has considering the ethical and professional taboos around violating the Goldwater rule. The limitations of this indirect approach become clear to the reader, as the mental health professionals reach diverging pseudo-diagnoses of President Trump, partially from a result of their field of specialty and their personal and professional experiences.
However, as much as these contributors disagree about the exact mental health categorization to make about Trump, there were commonalities in their observations and conclusions made from the data available: the president seems to be at least in possession of a narcissistic personality disorder (NPD) of some kind, severely curtailing his ability to consider opposing perspectives that he takes not as constructive feedback but personal attacks on his self-perceptions as perfect, omniscient and powerful. Besides narrowing his exposure to opposing perspectives necessary expressed in the process of democratic governance, the contributors note that this NPD also could explain why Trump has surrounded himself with close family members and business acquaintances (from Jared Kushner to former adviser Steve Bannon), as they are more likely to enable the president's dangerous conception of reality (everyone is out to get him, especially women, minorities, immigrants, refugees, Muslims, etc.) rather than call him out on his "alternative facts" (Lee, 2017, p. 230). Moreover, having dictatorial role models only reinforces these tendencies, as the individual sees their vision vindicated by others practicing the same M.O. with varying degrees of success.
Okay, so the president may be mentally ill (as have 37 presidents before him), but are the people surrounding him and the larger country also mentally ill (Lee, 2017, p. 181)? The most interesting (and disturbing) part of the The Dangerous Case of Donald Trump is its assertion that yes, to a certain degree, all people are mentally ill, yet tend to suppress or not acknowledge the darker tendencies of human nature (scapegoating of others, selfishness, violence, etc.). This ultimately hides the dark undercurrents of any society and leaves them dangerously unaddressed and easier to exploit by an authoritarian-minded leader who mobilizes society by motivating people in defense of the nation (read: the leader and his/her objectives) by funnelling populist energies towards the targeting of selected Others with whom we identify both as the source of all of our troubles and also the unwanted dark sides of our own selves. We've all seen where this leads, when people elevate a certain figure above all others as omniscient and able to solve all their inner problems and grievances. History has shown us this time and time again, with Hitler being the more prominent historical example in recent memory. But just imagine if Hitler had access to nuclear weapons or the full powers of one of the most powerful states in the world. Those are the stakes of today's present political situation.
The urgent questions this book forces all readers to consider (readers of all political persuasions) mean that The Dangerous Case of Donald Trump ultimately succeeds in at least effectively persuading people to critically think about the potential paths our nation could take in the present moment and how to counteract it. Perhaps the time has come to at least consider the possibility of mandated mental health treatment for prominent members of the executive branch. It might be the only surefire way to see dangerous mental health issues before they paralyze not only the affected individuals, but also the country and larger world. It is certainly not a time to do nothing and wait for the worse to happen.
Works Cited:
Lee, Bandy. (Ed.). (2017). The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin's Press.
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