but it's one that's being asked
on every major news network in America.
President Trump's fitness for office
is now the top story in the country.
Reports suggest that even
Trump's advisers are worried about it.
Everyone around the president questions
his intelligence and fitness for office.
100 percent of the people around him.
Concerns have gotten so bad that Trump
agreed to be screened for dementia
as part of his last health exam.
None of this has to do with Trump's
political positions.
They have to do with his ability to
understand the world around him
and make good decisions.
Everybody wants to know: is this president of sound mind?
And if talking about this kind of thing
makes you uncomfortable,
wait 'til you see how much it's stressing
out actual mental health experts.
In a series of tweets, the president insisted
that he is "like really smart" and a "very stable genius."
Last October, a group of 27 mental health
experts
published this book:
The Dangerous Case of Donald Trump.
In it, they warn that Trump's behavior
shows him to be dangerously unstable,
describing him as a pathological narcissist
who's delusional, suffers from paranoid ideation,
lacks conscience and empathy, and exhibits
a host of destructive and dangerous psychiatric symptoms.
Yeah, it's rough.
Two months after its publishing,
the book's editor met with 12 US senators
to talk about Trump's mental fitness.
That editor's name?
Dr. Bandy Lee.
I am a forensic psychiatrist at Yale School
of Medicine
and an internationally recognized expert on
violence.
Since the book came out, Dr. Lee has become
kind of the face of mental health experts
warning about Trump.
We express our consensus view that
Some of the psychological signs are:
All of these are highly associated with violence.
One thing I noticed is that she starts
almost every interview about Trump by saying
this:
I'd like to make clear that I speak for myself
She did it in our interview too.
That's because what Dr. Lee and her colleagues
are doing,
discussing the mental health of a politician
who isn't their patient,
is pretty controversial.
And to understand why, we have to go back
to 1964.
Don't tune out.
I'll make this quick.
Back then, Republican Sen. Barry Goldwater
was running for president.
He was a far-right candidate who talked openly
about wanting to use nuclear weapons
and was endorsed by the KKK.
I know, time is a flat circle.
In response to Goldwater's candidacy,
Fact Magazine published this piece,
in which over 1,000 psychiatrists argued
that he was psychologically unfit to be president.
Goldwater lost the election,
but he sued the magazine's publisher for libel
and won, causing the magazine to shut down.
In response, the American Psychiatric Association
created this guideline,
which states that when it comes to public
figures,
it is unethical for psychiatrists to offer
a professional opinion
unless they've conducted an examination on
that person.
They called it:
the Goldwater Rule.
Well, I was going to say it.
But yeah, the Goldwater Rule.
Which brings us back to this book.
Lee and her colleagues argue that they're
not violating the Goldwater Rule because
We're not interested in making a diagnosis.
They're assessing how dangerous he might be
based on his public behavior.
Most of the information that you get about
dangerousness
comes from observation of their behavior,
watching their interactions with people,
assessing them in real situations,
reports of how they respond,
objective signs that we can still evaluate
even if it's not enough to make a diagnosis.
But in March, the APA expanded the Goldwater
Rule,
clarifying that rendering any professional
opinion
about a public figure's affect, behavior,
speech,
or other presentation is unethical.
In other words, unless Trump agrees
to a full mental health screening
— never going to happen —
tons of psychiatrists are basically barred
from commenting on his mental health.
And that is very alarming to me.
Many people call it a gag rule.
Gag rule, I'm into it.
You would be.
That gag rule has a big impact on how the
media
talks about Trump’s mental fitness.
Lee worries that if they can't talk to mental
health experts,
journalists are more likely to normalize
Trump's abnormal behavior.
Most people are not used to seeing impaired
individuals
day in and day out, so
It's tough to grapple with the possibility
that
the person in charge of our nuclear arsenal
might be deeply unstable.
So instead, our brains look for other explanations
for Trump's behavior.
I want to believe he's just dishonest, not delusional.
Trump peddles conspiracy theories about
Obama's birth certificate, and he's just playing
to his base.
Is there some strategy in bringing up
the Obama birth certificate thing again?
Trump is not delusional.
He's being very politically savvy.
What should be evidence of a serious emergency
gets downplayed as just Trump being Trump.
Donald Trump's a different type of guy.
I mean, he operates differently.
That difference has made him very successful.
One of Lee's colleagues has a great name
for this phenomenon.
He calls it "malignant normality."
Ooh. I know.
It's a great drag name.
The result is that journalists end up missing
big danger signs,
signs that mental health experts could catch.
Pundits will simply say, “That's just Trump
being Trump,”
or, “It's tough talk.”
One crucial contribution
that mental health professionals can make is to
But the bigger problem with the APA's gag
order
is that it surrenders debates about Trump's
mental fitness
to non-experts.
Isn't it remarkable that we're talking about
the president's mental state?
To political commentators or partisan pundits
who actually aren't qualified to talk about this.
I'm not a doctor, but I can tell you what
I see and hear.
I'm not a doctor, but I can see that he is
not the sharp mind that he was.
I'm not a doctor, but his behavior is erratic.
To me, that's classic narcissism.
I'm not a doctor but...
Leaving mental health issues to pundits, non-professionals,
can keep the public in the dark and keep them
confused.
These discussions can quickly become train
wrecks,
where mental fitness is used as a weapon
to smear political opponents.
So many of the traits of a sociopath this
man is displaying.
I can't explain this crazy behavior, but I
can call it crazy.
You saw it during the Obama years, when Fox
News
regularly made wild accusations about Obama's
mental state.
We all know that Obama is a narcissist,
but this is bordering on the pathological.
He doesn't seem to have empathy or feelings
for Americans.
He is certainly unfit to be president.
And Lee worries that this kind of coverage
trivializes real concerns
about Trump’s mental fitness, reducing them
to
just another talking point for pundits to
argue about.
As this conversation escalates,
both sides sort of retreating to their corners.
The more that mental fitness sounds like
a left-wing talking point,
the harder it is to take it seriously.
To now say, “Oh, well, look, he seems unhinged,”
does seem like you're not willing to accept
the political reality that you are living
with.
To accept that it is simply a political issue
or a partisan issue
is an attempt to normalize the discourse.
No one's a doctor tonight that I've seen.
And somehow say, because you don't like
what he said tonight in his speech,
that he's somehow unfit to be commander in
chief,
that is the most ridiculous...
Whoa, whoa, whoa, everybody stop, stop.
The original goal of the Goldwater Rule
was to help prevent mental health from being politicized.
But if the last few months have shown anything,
it's that silencing mental health experts
does the opposite.
Politicization is almost inevitable without
expert input.
Mental health expertise, just like medical
expertise,
is neutral on all those grounds.
Trump has made questions about his mental
fitness unavoidable.
What remains to be seen is whether actual
experts
will be allowed to answer them.
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