2017-02-22

TUESDAY, FEBRUARY 21, 2017

This discussion ain't going to happen: What is the state of Donald J. Trump's mental health?

Is it possible that he suffers from some sort of early onset dementia? Is it possible that he is "mentally ill" in some way?

Despite an array of peculiar behaviors by the aforementioned President Trump, it seems fairly clear that this discussion isn't about to happen. We say that in spite of Lawrence O'Donnell's intriguing segment last night.

Should we have some such discussion? The New York Times has made a few feints in that direction, but Sunday's column by Professor Richard Friedman struck us as maybe, possibly and perhaps typical New York Times work.

According to the Times, Friedman is "a professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College." He's a "contributing opinion writer" to boot.

In his somewhat frustrating piece, Professor Friedman asserted several somewhat contradictory points. The gentleman's nuance was running amok. Let's get started with this:

FRIEDMAN (2/19/17): [I]n 1973 the A.P.A. developed the Goldwater Rule. It says that psychiatrists can discuss mental health issues with the news media, but that it is unethical for them to diagnose mental illnesses in people they have not examined and whose consent they have not received.
It sounds like it would be unethical for a psychiatrist to tackle this type of topic. Hold on though! Not so fast, Friedman says:

FRIEDMAN (continuing directly): Contrary to what many believe, this rule does not mean that professionals must remain silent about public figures. In fact, the guidelines specifically state that mental health experts should share their knowledge to educate the public.

So while it would be unethical for a psychiatrist to say that President Trump has narcissistic personality disorder, he or she could discuss common narcissistic character traits, like grandiosity and intolerance of criticism, and how they might explain Mr. Trump’s behavior. In other words, psychiatrists can talk about the psychology and symptoms of narcissism in general, and the public is free to decide whether the information could apply to the individual.

This may seem like splitting hairs, but it isn’t. Diagnosis requires a thorough examination of a patient, a detailed history and all relevant clinical data—none of which can be gathered from afar. Narcissism, for instance, isn’t the only explanation for impulsive, inattentive and grandiose behavior. Someone could be suffering instead from another clinical problem like attention deficit hyperactivity disorder; the abuse of drugs, alcohol or stimulants; or a variant of bipolar disorder, to name just a few.

This is all to say that when mental health professionals label public figures with mental illnesses, it is not just unethical—it’s intellectually suspect. We don’t have the requisite clinical data to know what we are talking about.
We'd hate to see the professor start "splitting hairs" if he feels this passage doesn't qualify as an example of same. And uh-oh! As several commenters noted, he said it's unethical and intellectually suspect to label public figures with mental illnesses, but then went on to say this:

FRIEDMAN (continuing directly): Besides, even if you posit that a president has a mental disorder, that in itself may say little about his fitness to serve. After all, Lincoln had severe depression. Theodore Roosevelt was probably bipolar. Ulysses S. Grant was an alcoholic. According to a study based on biographical data, 18 of America’s first 37 presidents met criteria suggesting they suffered from a psychiatric disorder during their lifetime: 24 percent from depression, 8 percent from anxiety, 8 percent from bipolar disorder and 8 percent from alcohol abuse or dependence. And 10 of those presidents showed signs of mental illness while they were in office.
Some commenters said he ended up diagnosing everyone but Trump!

Last evening, on The Last Word, Lawrence O'Donnell hosted two guests who seemed to reach different conclusions. One of Lawrence's guests said that "a thorough examination of a patient" ha been shown to be the least effective available way of reaching a diagnosis.

We'd love to show you what these guests said, but MSNBC hasn't come up with a transcript yet. Nor has it posted the videotape of this intriguing segment.

The Channel tends to function this way. So much for thoughtful discussion! Have we mentioned the fact that Donald J. Trump has the nuclear codes?

In our view, we've been well served, in the past fifty years, by the general rule which held that psychiatric analysis should be eliminated from political discussion. In view of Trump's many peculiar behaviors, including his strange intellectual conduct, it seems to us that it may be time a change, challenging though such a discussion would be.

The Time has responded to this concern with a somewhat puzzling essay. MSNBC can't seem to get around to posting its work at all.

In theory: In theory, our dear Watsons, the transcript will show up here.

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