Psychiatrists Brandy Lee and Leonard Glass are leading a campaign to convince the public that President Trump is a danger to the country. In a piece written for Politico Magazine today, they argue that their efforts do not violate the longstanding “Goldwater rule” against making a diagnosis of a public figure without examining that individual in person. The Goldwater rule was put in place in 1973 by the American Psychiatric Association after a group of its members signed a letter saying Barry Goldwater was unfit to be president. The NY Times described the genesis of the rule here:
In the midst of a deeply divisive presidential campaign, more than 1,000 psychiatrists declared the Republican candidate unfit for the office, citing severe personality defects, including paranoia, a grandiose manner and a Godlike self-image. One doctor called him “a dangerous lunatic.”
The year was 1964, and after losing in a landslide, the candidate, Senator Barry Goldwater of Arizona, sued the publisher of Fact magazine, which had published the survey, winning $75,000 in damages.
But doctors attacked the survey, too, for its unsupported clinical language and obvious partisanship. In 1973, the American Psychiatric Associationadopted what became known as the Goldwater Rule, declaring it unethical for any psychiatrist to diagnose a public figure’s condition “unless he or she has conducted an examination and has been granted proper authorization for such a statement.”
According to Lee and Glass, their collection of essays on Trump’s mental state doesn’t violate that Goldwater rule because they aren’t diagnosing Trump, they are just assessing his “dangerousness.” Here’s the key paragraph from their Politico piece explaining the difference:
All 27 experts who contributed to The Dangerous Case of Donald Trump took pains not to diagnose the president in the book. (Bandy, who edited the book, is a strong proponent of the Goldwater rule and particularly opposes modifying it under political pressure.) A formal psychiatric diagnosis is reached after careful study of the patient, including taking a history, performing a physical, reviewing lab results and history of past illnesses and treatments, and obtaining supplementary perspectives from close family members. A diagnosis forms the basis for a treatment plan individually designed for that patient’s future care. An individual’s dangerousness, however, can be reliably assessed by interviewing co-workers and intimates, reviewing the individual’s past statements and behaviors, reviewing police reports and, crucially, assessing context. While an in-person interview can be quite useful, it is not strictly required to assess danger.
The authors claim they aren’t making a diagnosis because they aren’t trying to treat Trump, just trying to determine how much of a threat he represents. But is it true? The dictionary defines the word diagnosis as “the process of determining by examination the nature and circumstances of a diseased condition.” This is how most people understand the word. It’s how it’s used in a doctor’s office and how it’s used on television. When something is wrong a doctor attempts to diagnose the cause of the problem from the symptoms. I haven’t read The Dangerous Case of Donald Trump but according to this Washington Post review, the book suggests a number of different diagnoses for what is wrong with Trump:
Trump displays signs of “extreme present hedonism,” the tendency to live in the moment without considering consequences, seeking to bolster one’s self-esteem no matter the risk. Or he exhibits “narcissistic personality disorder,” which includes believing you’re better than others, exaggerating your achievements and expecting constant praise. Combine hedonism, narcissism and bullying, and you get “an impulsive, immature, incompetent person who, when in the position of ultimate power, easily slides into the role of the tyrant,” Philip Zimbardo (of the famous Stanford prison experiment) and Rosemary Sword write. Others suggest that Trump shows indications of sociopathy, including lack of empathy, absence of guilt and intentional manipulation. Put it all together and you have “malignant narcissism,” which includes antisocial behavior, paranoid traits, even sadism.
“Mr. Trump’s sociopathic characteristics are undeniable,” retired Harvard psychiatry professor Lance Dodes concludes.
As the Post points out, at least one of the authors even equivocates on this very point: “Am I making a diagnosis of President Trump?” psychiatrist Henry J. Friedman asks. “Well, yes and no — and even maybe.” Finally, there’s some evidence that the authors themselves are somewhat biased in their outlook. From the Post’s review of the book:
It’s hard to read “The Dangerous Case of Donald Trump” as simply the dispassionate insights of well-trained experts. “The majority of mental health professionals tend to be liberal in their leanings,” admits clinical psychologist Jennifer Contarino Panning, while psychiatrist David M. Reiss cautions that “those who speak out must do so carefully, not without risk, and to a populace that should be reasonably skeptical.” Comparisons between Donald Trump and Adolf Hitler abound in this volume. “History will not be kind to a profession that aided the rise of an American Hitler through its silence,” clinical psychologist John D. Gartner writes in a typical passage. MIT linguist Noam Chomsky makes an odd cameo in the book’s epilogue, warning that the Trump administration may stage a fake terrorist attack. And clinical psychologist Michael Tansey suggests, with disdain and needless vulgarity, that “there is considerable evidence to suggest that absolute tyranny is DT’s wet dream.”
Not coincidentally, Lee and Glass close their Politico Magazine piece with a similar comparison:
In early 20th-century Germany, the sociologist Max Weber argued that intellectuals should not utter any political opinions or say anything that could remotely be regarded as partisan—a Goldwater rule of sorts for the era. Under Nazism, not only psychiatrists but most German clergymen, professors, lawyers, doctors and other leading thinkers became passive enablers of some of the worst atrocities under a dangerous political leader who led their country into the worst disaster in its history. It was precisely in response to Nazism that the World Medical Association issued its Geneva Declaration. Seventy years later, we must not forget the declaration’s commitment to the common good, and cannot stay silent.
So after spending most of their piece claiming they haven’t violated the Goldwater rule (at least their preferred version of it), the authors conclude by suggesting it should be violated if we’re to avoid the fate of Nazi Germany. Note that last line about 70 years later. She’s bringing us back to the present day. So, without quite saying so, the comparison is once again made between President Trump and Adolph Hitler.
All of this would be a lot more convincing if progressives hadn’t spent years making similar claims about George W. Bush (who was also compared to Hitler), Ronald Reagan, and, yes, Barry Goldwater. It all seems to be part of a script. The constant agitation about the danger presented by giving Trump the nuclear codes dates back to this infamous political ad from 1964. In hindsight, most people realize this sort of thing is simply fear-mongering but I’m sure the doctors who condemned Goldwater (and thus prompted the Goldwater rule) didn’t see it that way at the time.