Stop! Trying to diagnose Donald Trump…

nbc-fires-donald-trump-after-he-calls-mexicans-rapists-and-drug-runners

It’s probably important to start this piece with a clear position statement: There are approximately two issues upon which I agree with Trump (globalization has hurt lower and middle class employment, and the U.S. does have a bloody history [although I don’t agree this defends Putin]) and pretty much everything else about Trump I am strongly opposed, if not in radical opposition to.

I also think there are numerous psychological arguments against his practice as president, for example it’s fairly robustly shown that the attitudes of authority figures ‘trickle-down’ into a culture, and outright prejudicial policy encourages day-to-day prejudice, racism, sexism and so forth. Not to mention his wrong-headed approaches to ASD and offensive comments on disability. I could go on….

But

BUT

BUT

This recent trend of trying to diagnose Donald Trump I cannot condone or support and even feel the need to write this post in opposition!

This is going to take a bit of background so bear with me…

Firstly there is a ‘Goldwater rule’ eschewed by the APA (American Psychological Association) which deems it unethical and inaccurate to provide diagnosis for people that the professional has not personally examined.  This was originally intended to prevent professionals claiming public figures had mental illnesses, but lets be honest it bloody good advice in general (psychologist do find themselves expected to provide a diagnosis based off family member or other professionals report!).

Now a lot of people seem to be outright ignoring this ruling in regards to Mr Donald J Trump. A significant portion of those people are armchair experts, who despite my frustration aren’t really bound by any professional standards, but more and more qualified professionals are weighing in, including I’ve heard of a group calling themselves ‘Duty to Warn’ (based off the concept that a therapist breaks confidentiality if the duty to warn and prevent harm is more than the need for privacy). This group apparently contains psychiatrists and psychologists, so isn’t just a gathering of free citizens making an opinion.

People seem to be using the following arguments to justify their unethical practice:

  • Trump is public enough to provide adequate evidence for diagnosis or
  • The risk is high enough to justify the practice

Terms like psychotic dementia, narcissistic personality disorder, and paranoid delusion have been bandied about. Perhaps ironically this post’s intent is not to rule these out (because equally ethically one cannot confirm the non-existence of these disorders)

In regards to justifications, the problem with the first is that it is inaccurate. When making a diagnosis quantity of information does not beat quality. For example most diagnosis requires some data across contexts. Public speculation about what Trump is like in the White House does not count. Public appearances are problematic because even though they might not be ‘acting’ we all act in public, not to mention that even though Trump appears diabolical to most there is no evidence that he has been quite intentional with his actions – misleading, distracting, and pushing buttons. Most sane people might be distressed by this, but that is not quite the criteria for mental disorder.

The second justification is much more problematic. It does pose an interesting question, as this so-call group have named themselves ‘duty to warn’ professionals often have a duty to break confidentiality. The claim that Trump is so dangerous it justifies unethical diagnosis is tempted however there are many flaws with the argument primarily: Breaking confidentiality to warn people has a direct link with the ethic broken and the harm reduced – i.e. in order to prevent a greater harm (someone getting hurt) a lesser harm is caused (privacy is violated). When it comes to unethically (and inaccurately) diagnosing a president what harm is reduced? It’s highly unlikely that Trump will lose his post due to outside professionals throwing around diagnosis – not to mention mental disorder is not the typical route to removing a president (i.e. elections and impeachment) I realize it might contribute to an impeachment but its an unlikely spark for that fire (unless it comes from within the White House of course)

Furthermore an increase in risk doesn’t improve the accuracy issues. If said professional had examined Trump and were releasing confidential information this would be a different question. Contrary to how we feel, need doesn’t change reality. Being poorer doesn’t increase the likelihood of winning lotto. The more politically offense Trump is doesn’t make distance diagnosis more accurate even if it were deemed justified from a harm perspective.

What really bugs me about this whole deal is the weaponization of mental illness stigma from people who should know better. At the end of the day this is political mud slinging under the guise of professional qualification, I have no problem with professionals having political opinions, it is after all the whole deal with democracy. But one should not use their expertise for evil as it were. Not only does it stigmatize the genuinely unwell it also brings the profession into disrepute, mental diagnosis is not about political point scoring but for better understanding challenges and suffering and how to help people going forwards.

I want to see the guy out of office as much as anyone, but more importantly I don’t want to see my profession drag itself into the mud under misguided assumptions of ‘duty.’ There are a myriad of ways to use psychology to criticize Trump effectively and legitimately, without resorting to unethical and inaccurate practice.

Rant over

 

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