Gandering the Golden Goose -- Three Tough Decisions Obfuscated by the Trumpets of Campaigning
Tip that Canoe and Dump Tyler, Too
It Broke the Straw on the Camel's Back
Language is a knife that cuts every which way and loose. We’re thinking of three bits of language, describing three types of behavior that are the consequence of suffering through opposing goods …
- Journalistic Neutrality ... The decision to err on the side of fairness by neutering the powers of the Fourth Estate in the face of someone who likely acts out in ways that may be detrimental to the entire engaged society or even the World.
- Racial/Ethnic Profiling ... The decision to err on the side of abbreviating an individual's rights that protect her/him from illegal search and seizure rather than equal protection under the law of the suspected which would neuter some of the testosteronic powers of our armed police force.
- The Goldwater Rule ... The decision to err on the side of protecting the public figure's privacy rights by neutering the powers of psychotherapists of all stripes to carry out their mandated requirement to report the likelihood of lethal damage by that public figure.
Some diplomats are breaking the article in the 1961 Geneva Convention which advises against speaking out on the politics of foreign nations (emphasis added), just as some psychotherapists, the authors among them, are speaking out against Trump using every relevant aspect of our special knowledge, most especially our expertise in diagnosis and our understanding of what some people with a certain diagnose are capable of doing as far as inflicting harm on others.
Article 41 of the Geneva Convention
1. Without prejudice to their privileges and immunities, it is the duty of all persons enjoying such privileges and immunities to respect the laws and regulations of the receiving State. They also have a duty not to interfere in the internal affairs of that State. www.mfa.gov.tr/...
Politico has an article about this changing among some diplomats because of Trump. (emphasis added) :
Trump has diplomats abandoning vows of silence
The Republican presidential candidate's international insults are making it tough for envoys to stay quiet as diplomatic custom requires.
By Nahal Toosi and Benjamin Oreskes
09/18/16 04:41 PM EDT
The Republican presidential candidate's international insults are making it tough for envoys to stay quiet as diplomatic custom requires.
NEW YORK — There's a longstanding custom among the world's diplomats: You don't trash-talk candidates running for office in a foreign country.
Donald Trump is close to destroying that tradition.
As thousands of diplomats gather for the U.N. General Assembly here this week, many are struggling to hold their tongues about the brash billionaire running for the White House, a man who has managed to tick off much of the planet.
“If you represent one of these countries that has been insulted or attacked, you tend to react,” said one Latin American diplomat attending the General Assembly. Speaking of his own background, he told POLITICO, “We are very passionate, and our blood is pretty hot. But we have to play it cool and understand that this is a campaign, and an election, and that we are diplomats.”
To be fair, Trump's candidacy is testing the norms of plenty of professions, including journalism and psychiatry. But perhaps nowhere are the stakes higher than the realm of international relations. CONTINUED
The last paragraph (emphasis added) led two of your Daily Kos diary psychotherapists to reopen the discussion about whether we have been justified in using diagnosis terms and even postulating a diagnosis for Trump. (Hal’s diaries. Howard’s diaries)
As for diplomats, a few world leaders have come out with highly negative views about Trump (from the same article)
But in 2016, the Mexican president has compared Trump’s rhetoric to that of Adolf Hitler; the German foreign minister has warned that the Republican’s fear-driven brand of politics would be “dangerous” for the whole world; and the French president has said the real estate mogul’s “excesses” provoke a “retching feeling.”
While not diplomats, lawmakers in the United Kingdom even debated banning Trump from visiting.
Other diplomats have chosen to remain more “diplomatic,” for example:
It doesn't help, several foreign diplomats have privately said, that Trump's campaign structure is so opaque and his policy positions so mercurial.
"For our people in Washington, Trump is an enigma. When they look at his foreign policy views and advisers they're scratching their heads," a U.N.-based European diplomat said.
At a recent gathering in Washington, D.C., a handful of European diplomats were urged to share their true feelings about the U.S. presidential candidates.
David O’Sullivan, the European Union's ambassador to the United States, quipped that his confidential cables to his superiors back home about the election "will have to remain something that only future historians will read."
But, he added: "There’s a sense that this election is different from previous ones. But maybe there’s a temptation always to think that about every election.”
If you haven’t been following them, many of our diaries are about the psychopathology of Donald Trump. As experienced diagnosticians we analyze our myriad observations of Donald Trump’s behavior (his temperament and disposition as evidenced by television and radio, as well as accounts of people who spent a lot of time with him, especially “Art of the Deal” author Tony Schwartz. Schwartz now calls Trump a “sociopath” (he isn’t) and say’s “I put lipstick on a pig.” But he also describes numerous observations and interactions with Trump when he was presumably let his guard down and this a rare treasure trove for experts to make a distance diagnostic assessment.
We have more information about Donald Trump by far than psychiatrists ever had about Barry Goldwater.
Here’s what the controversy in the mental health community is all about.
When Barry Goldwater was running for president a large group of psychiatrists wrote that he wasn’t fit to be president:
The issue arose in 1964 when Fact magazine published the article "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." The magazine polled psychiatrists about American Senator Barry Goldwater and whether he was fit to be president. In Goldwater v. Ginzburg Goldwater filed a libel suit in response to the article, he won $75,000 in damages. Wikipedia
Whether this was a decision based strictly on ethics or out of a fear of losing lawsuits only cynics would even consider.
The rule itself was formulated by the respected American Psychiatric Association. This is a professional association and membership isn’t required to practice psychiatry although most psychiatrists are members. It came out in 1973 and reads:
On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.
Of course, it is highly unlikely that a public figure who thinks there may be less than a clean bill of mental health is going to submit to a mental health examination and authorize public disclosure of the results.
What has happened with Trump is that a large number of psychotherapists have in various forms made public their opinions about Trump, obviously from their unique point of view, i.e., as mental health professionals. This isn’t like librarians or teachers coming out with negative opinions about Trump. When mental heath professions express such opinions they are quite obviously speaking from the standpoint of having special knowledge about psychopathology.
The controversy within the mental health field is between those who don’t want to make an actual diagnosis and those who do. Both groups think there are aspects of his personality that make him unfit or even dangerous to be president. The “don’t diagnose” group chooses instead to use words and terms that fit a diagnosis without actually making the diagnosis. The “it’s okay to diagnose Trump” group feels that the public is smart enough to see through the equivocating words (McAdams says “narcissism, disagreeableness, and grandiosity”) and see why these add up to a diagnosis which makes Trump not only unfit, but potentially dangerous to be president. Those of us who make and justify a diagnosis believe we should share our expertise to warn the public that because of what they have concluded is his diagnosis he represents a danger.
As most of you know, therapists have a duty to warn when the believe a client is a danger to self or others (it’s sometimes referred to as Tarasoff which you can look up). The authors believe that we are justified, and are acting ethically in ignoring the Goldwater rule and warning the public about Trump.
The psychological focus on Trump’s personality first came to national attention from the June cover story of The Atlantic, “The Mind of Donald Trump: Narcissism, disagreeableness, grandiosity—a psychologist investigates how Trump’s extraordinary personality might shape his possible presidency,” by Dan McAdams, Ph.D.
(McAdams) field is cited on Wikipedia as Narrative psychology and Thematic coherence. McAdams is the author of The Person: An Introduction to the Science of Personality Psychology, a classroom textbook. He co-edited, with Amia Lieblich and Ruthellen Josselson, the eleven-book series "The Narrative Study of Lives".
His three level model of personality  has been widely cited and was used in The Happiness Hypothesis book. The three levels are :
- Dispositional traits, a person’s general tendencies. For example, the Big Five personality traits lists: Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism.
- Characteristic adaptations, a person’s desires, beliefs, concerns, and coping mechanisms.
- Life stories, the stories that give a life a sense of unity, meaning, and purpose. This is known as Narrative identity.
We focus on this because this article because it seems to have opened the door to other mental health professionals coming out about their opinions about Trump. But it should be noted that McAdams, highly qualified in the study of personality, has not devote his career to abnormal personality and the diagnosis and treatment of psychiatric disorders.
Following this the next major publication to write about Trump’s personality was the New York Times on August 15th.
The 2016 Republican nominee’s incendiary, stream-of-consciousness pronouncements have strained that agreement (Goldwater rule) to the breaking point, exposing divisions in the field over whether such restraint is appropriate today.
Psychiatrists and psychologists have publicly flouted the Goldwater Rule, tagging Mr. Trump with an assortment of personality problems, including grandiosity, a lack of empathy, and “malignant narcissism.” The clinical insults are flying so thick that earlier this month, the psychiatric association posted a reminder that breaking the Goldwater Rule “is irresponsible, potentially stigmatizing, and definitely unethical.”
Putting a psychiatric label on a candidate they oppose can be a “seemingly irresistible tool for some in the field,” said Dr. Paul Appelbaum, a professor of psychiatry, medicine and law at Columbia University who disapproves of the practice. “This year, perhaps more than most, they’re persuaded they’re saving the nation from a terrible fate.”
The New York Times article publicized a project begun by psychologist William Doherty, Ph.D called a manifesto, which we recommend you read here. Dr. William J. Doherty, Ph.D., is a professor at the University of Minnesota in the Department of Family Social Science. He is author of a book on family rituals, titled “The Intentional Family”. From what we can tell, he is not an expert on psychopathology, and on the diagnosis and treatment pf psychiatric disorders, as the author of this article are.
The manifesto was signed by over 2,200 therapists. The authors of this articles were both banned from posting our disagreements about diagnosing Trump on the sites private discussion Facebook page. Consider that Doherty says this:
Sign the manifesto and join the Facebook group. Learn from colleagues, share your own passions, and decide what voice, if any, you’d like to have in the public sphere. You may surprise yourself, for example, by wanting to write blog posts that connect this initiative with your clinical passion areas, or share blog posts that your colleagues create.
You can see why it surprised us when we tried to discuss whether we had a case for making a public diagnosis and were personalty banned from doing so by Dr. Doherty. So much for free private debate among psychotherapists who disagree with the view of the person who opened the Facebook page supposed to discuss issues related to Trump’s fitness for office.
When you read the manifesto with it’s long list of personality traits which disqualify him from being president and labeling them adding up to “Trumpism” is the same as diagnosing him, albeit with a diagnosis that is not in the current Diagnostic and Statistic Manual (DSM-5 which thanks to Trump tens of thousands of laymen now are familiar with).
In point of fact, “Trumpism” as defined in this manifesto is a far more dangerous disorder than the one most psychotherapists have agreed he probably suffered from, narcissistic personality disorder.
We don’t think the disclaimer here makes any sense:
Trumpism is an ideology, not an individual, and it may well endure and grow after the Presidential election even if Donald Trump is defeated. (Variants can be seen all over Europe.) Trumpism is a set of ideas about public life and a set of public practices characterized by:
Trumpism is not an ideology, it is a psychopathology notable for beliefs and behaviors which include the following. These are symptoms of a severe psychiatric disorder, what we sometimes refer to as a constellation of disorder which includes symptoms like pathological lying, hedonism, and extreme misogyny which current don’t fit into the diagnostic manual.
- Scapegoating and banishing groups of people who are seen as threats, including immigrants and religious minorities.
- Degrading, ridiculing, and demeaning rivals and critics.
- Fostering a cult of the Strong Man who:
- Appeals to fear and anger
- Promises to solve our problems if we just trust in him
- Reinvents history and has little concern for truth
- Never apologizes or admits mistakes of consequence
- Sees no need for rational persuasion
- Subordinates women while claiming to idealize them
- Disdains public institutions like the courts when they are not subservient
- Champions national power over international law and respect for other nations
- Incites and excuses public violence by supporters
As experienced clinicians we have been able to explain why some of the diagnostic terms being bandied about regarding Trump are wrong, most notably that he’s a sociopath.
We see it as an ethical responsibility to help the public learn to use the tools of the mental health profession responsibly, not to become armchair psychologists, but to understand the basics of gathering evidence to factor into the rather easy to understand lists of criteria in the DSM-5 used to make a diagnosis.
Some psychotherapists seem to want to make psychiatric diagnosis seem far more complex than it really is. We’re not taking about a rare brain disorder or tropical disease. While there are some psychiatric conditions that take numerous sessions to diagnose and sometimes referrals to specialists, most can be diagnosed tentatively in 1-3 sessions.
The authors of this article have 80 years of clinical experience diagnosing and treating thousands of clients. We believe we have at the least as much information about Trump, if not more, than if we saw him face-to-face as a patient to make a diagnosis (always with the caution that meant health diagnoses are always tentative and open to revision based on new information coming from the client or those who observe the client.)