A recent diary called for mental health professionals and the associations that represent us to take a public stand against Donald Trump based on the author’s belief that Trump has a diagnosable mental disorder. I’m not going to call out the author here — that’s not the point, because he’s not the only one who’s made this plea. But as a fellow mental health professional, also with decades of experience as a clinician and clinical supervisor, I feel obligated to post this diary as a counterpoint.
It’s a terrible idea to call for the American Psychological Association or American Psychiatric Association to engage in diagnosis-at-a-distance in order to neutralize a political opponent. Advocating for that sort of thing is not just thoughtless — it’s dangerous to what we stand for as progressives.
The U.S. has a troubling history of using psychology and psychiatry as a means to silence and marginalize people — most recently, psychology was used to develop torture techniques used in Iraq, and currently, Vice President-elect Pence advocates for an abusive type of pseudo-therapy (“conversion” or “reparative” therapy) that claims (falsely) to “cure” GLBT persons. While it’s true that conversion therapy has been rejected by the APA and is illegal in many states, it’s important to know that conversion therapy is not illegal in all states. And some states where it’s been disallowed are now suing for the right to use it again.
So before you go asking for mental health professionals to use diagnosis as a political tool, please think again.
I am quite comfortable with using my training to help people better understand the traits we see in Trump. No, he’s not senile. No, he’s not going to change. Yes, he has obvious narcissistic traits. Yes, he shifts moods and decisions and policies based on whoever is saying nice things about him at the moment. Yes, that’s dangerous in a President. Yes, we have to do something about it.
But here’s a reality check. There are people with personality disorders — including extreme manifestations of those disorders - in positions of power throughout our society. Many bring chaos, pain, and even destruction to colleagues and loved ones. But some possess great skill, and others are thought leaders who are able to create real change. They may be an absolute nightmare as a boss or colleague, and it may be virtually impossible to establish a friendship or loving relationship with them. But they can be effective.
Trump is unstable and unfit to be our president, but it isn’t a diagnosis that makes that true. And putting all of the emphasis on a diagnosis over-simplifies what’s actually going on. It also minimizes the experience of millions of Americans who live with a mental health disorder and are living examples of the fact that who we are is not defined by a diagnosis.
What can we do? We can learn to recognize toxic patterns of behavior when we see them, regardless of whether they have an official diagnostic label. We can stand up and refuse to let those patterns be normalized just because someone in power is engaging in those behaviors. We can refuse to be exploited and abused, and can act to protect the vulnerable from being exploited and abused. Sometimes in order to do that we’ll need to reach out to others for help, validation, and support. Sometimes whole communities will need to do that. Right now a whole country needs to do that.
We’re not going to eliminate people with personality disorders from our personal lives or our work lives or our political lives. And there are plenty of people who are toxic, but who really don’t fit neatly into any diagnostic category. They’re just jerks. Our task, regardless of whether someone has a formal diagnosis or not, is to expect and work toward honest business practices, respectful discourse, ethical politics, and sensible and compassionate policies. Shouting diagnostic labels at people doesn't help with any of that.
We can and must resist Trump’s poisonous brand of politics. And I’ll gladly stand with all of you who plan to work toward a better future for this country than the horror show Trump would visit upon us. If my training can help illuminate some of the patterns and traits you’re observing and can offer suggestions for how to counter them, I am completely on board with that.
But don’t ask me to turn my skill and training as a mental health professional into a political weapon. It’s misguided and unethical, and when it’s been done in the past, the results have been very ugly. We’re better than that, and we can defeat Trump without going down that very dark path.
