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During the past few weeks there have been increasing references in the media with regard to Donald Trump’s mental health. Along these lines some have questioned whether psychologists and psychiatrists should continue to adhere to the Goldwater rule, which forbids professionals from diagnosing political figures. What is interesting to me is not whether those in the psychological professions should or should not diagnose Trump. Instead I am interested in the concept of mental illness itself and its limitations in the political sphere. I also want to explain why this discourse should be resisted, while we seek to use other descriptive ways to understand and critique Trump and his leadership style.
The idea of mental illness is both tricky and complex. In some ways, it stands as a metaphor for understanding abnormal behavior and/or mental suffering. I say metaphor, because it refers to a concept “mind” and not the brain. To be sure, there are clear examples of brain malfunctions, which are seen in mental suffering such as schizophrenia and bipolar disorders. And there are, in some cases, genetic factors at play in these and other illnesses. But the waters get murky when we note that in the Diagnostic Statistical Manual for Mental Disorders (DSM) there are mental illnesses such as narcissistic or borderline personality disorders. Can we locate brain malfunctions using the MRI or genetic testing in these mental illnesses? The simple answer is no. These disorders reflect patterns of behaving and thinking that are deemed abnormal, unhealthy, or socially disruptive. To add to the complexity, there are questions not only about what abnormal or healthy means, but also who has the power and authority to diagnose? Who defines what is mentally healthy and what is not? Any cursory reading of the history of Western psychology will reveal all kinds of abuses in psychological diagnoses and treatments. Moreover, the psychological professions have often wittingly and unwittingly serve as disciplinary regimes for cultural and conservative political-economic forces (Cushman, 1995). Abuses and collusion with political-economic forces and structures can also raise questions about the motives and aims of professionals treating people who were either marked as abnormal or who were designated as mentally ill. Is treatment really for the benefit of the sufferer or for the “security” of the larger public order, or the profits of insurance companies?
Even if we concede that some people have the social authority to diagnose behavior as abnormal, there are related questions of what normal psychology/behavior is and what is abnormal. Decades ago, Psychoanalyst R.D. Laing (1969) responded by calling into question what is deemed to be normal and abnormal, sane and insane:
A man who prefers to be dead rather than Red is normal. A man who says he has lost his soul is mad. A man who says that men are machines may be a great scientist. A man who says he is a machine is “depersonalized” in psychiatric jargon. A man who says that Negroes are an inferior race may be widely respected. A man who says his whiteness is a form of cancer is certifiable. A little girl of seventeen in a mental hospital told me she was terrified because the Atom Bomb was inside her. That is delusion. The statesmen of the world who boast and threaten that they have Doomsday weapons are far more dangerous, and far more estranged from “reality” than many of the people on whom the label “psychotic” is affixed. (pp.11-12)
Laing points out that sometimes what is deemed to be normal or common is often insane, as in unhealthy. There may, in other words, be logic to the doctrine of mutually assured destruction (MAD), but it is a kind of madness—madness deemed to be both normal and common. To turn to the present occupant of the White House, if we consider his bombastic, bloviating texts, they are not necessarily abnormal in light of the larger culture of narcissism (Lasch, 1979). His behavior and attitude, however churlish, are quite normal—normal as in common.
Let’s remain for a moment in the area of normal and abnormal with regard to mental illness. Decades ago journalist and philosopher Hannah Arendt was assigned to cover the Eichmann trial in Israel. Eichmann was a lieutenant colonel in the SS tasked with insuring that the Nazi machinery of death functioned well. Eichmann, like other Nazi leaders interviewed after World War II (Lifton, 1986), was not mentally ill. If Eichmann was not mentally ill, how then were people to understand his appalling and seemingly abnormal thinking and behavior? Arendt described Eichmann as incurious and thoughtless or we could say unreflective—a man preoccupied about himself and the advancement of his career. He was a functionary in the German machine and focused on executing the orders he received from his leaders. Given what she heard and observed, Arendt eschewed psychological categories, using a phrase the “banality of evil” to refer to Eichmann. She was wrongly condemned for minimizing evil, but in fact her use of the term “banal” did not refer to common, but rather to the thoughtlessness and insensitivity of the man who had been a key figure in the murder of millions of Jews. Was Eichmann’s behavior abnormal? Was his thinking abnormal? People like Eichmann were in fact quite normal both in the sense of not being mentally ill and in the sense of being quite common in that society.
While people may blanch at the connection between Eichmann and Trump, I see a number of links, as well as differences. Trump’s lack of curiosity is well known. He has in the past bragged about not reading books, except perhaps for those written about him. There is little evidence of his being reflective or thoughtful. Instead, he uses simple sentences and seems incapable of dealing with substantive topics and arguments. His patterns of public speaking are aimed not at thoughtfulness, but simplistic certainty. Thoughtfulness connotes some level of sensitivity, which is absent in the public figure who seems untouched by the consequences of what he says and does. He displays no sensitivity to the plight of immigrant Hispanic and Muslim families. He humiliated a disabled person, then denied it, seemingly more concerned about himself than the feelings of the person he publically humiliated. To be sure, he is capable of being sensitive, but sensitivity is reserved for those who like or agree with him. Also like Eichmann, Trump is preoccupied with his career (or rather his image and brand) and is resentful and vindictive toward those who get in the way or who criticize him. Trump also fits well with large segments of the population. In a culture of narcissism (Lasch, 1979), Trump is not abnormal, but common. Indeed, he is the cultural apotheosis of neoliberal capitalism’s homo economicus that is preoccupied with profit, prestige, and power. If Trump is mentally ill, then we must also agree that large segments of the U.S. population are mentally ill as well. Two differences from Eichmann: first, Trump is much more adept at advancing his career/image. Second, he currently has not been implicated in a machinery of murder.
The complexity of the category of mental illness and its attending problems in identifying abnormal and normal behavior suggest that mental illness is not a useful notion in political discourse and in understanding political leadership. Yet, there are other reasons why I wish to resist the use of mental illness in political discourse. Over nearly 30 years of treating people who suffer mentally, I have no desire to append that label on a man who is clearly not suffering. At least from what I have read and seen, he does not seem to be suffering and if he is, it is well hidden. To label Trump as mentally ill would, in my view, demean the courage, resilience, and hard work of those who have sought help for their mental suffering. Moreover, it further taints the category of mental illness by associating it with a man who seems fine with humiliating people with disabilities.
I also wish to avoid this kind of discourse because mental illness suggests a diminished capacity for responsibility. A person with schizophrenia is responsible, but we also know that making poor decisions and engaging in destructive behaviors are part of the disease. Culpability is lessened by virtue of his/her mental illness. I have no desire to let Trump off the hook for his poor decisions and the pain and suffering he is perpetrating on vulnerable people. I think it would be more accurate to move to the categories of sin and vice instead of psychopathology, because they connote a distortion of the will or responsibility, rather than a diminished capacity. I will address this further later.
The category of and discourse about mental illness vis-à-vis Trump is not fitting for other reasons. I have certainly thought about diagnosing Trump, but my intentions have nothing to do with my usual intentions in diagnosing patients. People in the psychological fields who care for patients suffering from mental illness ideally diagnose for the sake of the patient’s well-being. Yet, any competent professional will admit that diagnosing patients can be overdetermined in the sense that the psychologist’s or counselor’s motivation has more to do with him/her than it does with the patient. In the political sphere, I am not sure that the motivations of those who seek to diagnose Trump are pure or have his best interests in mind, though they may have in mind the health of the country or democracy. And I also wonder how useful it is to diagnose Trump when he shows no interest in learning about himself, let alone being open to treatment. Actually, I think the impulse to diagnose Trump as mentally ill reflects a politicization of the concept of mental illness, which in my view neither advances a cultural understanding and appreciation of mental illness nor contributes to political discourse. Indeed, the use of mental illness in this way actually is just one more type of ad hominem attack that masquerades as substantive political discourse.
If we decide to refrain from engaging in psychological diagnosis of the president, then what categories can we use to assess his leadership? What if we were to return to more traditional concepts, like virtue or character when assessing leadership? Surely this would interest Republicans who raised this in terms of Clinton and his behavior. Conservative politician William Bennet (1993) wrote a book about virtues and character formation, though lacking in at least one or two of the virtues himself. My interest is not to expound upon these terms. Rather, I wonder how political discourse is altered if we assessed political leaders in terms of virtues and character—politically understood.
Let’s go back to a founding figure of Western philosophy. Aristotle argued that the “polis existed ‘by nature’ because nature means us to live a good life in common” (Ryan, 2012, p.78). To live a good life in common requires virtues, not only of the citizens, but those charged with leading them toward the good. A contemporary philosopher, Alasdair MacIntyre (1984), informs us that virtue is “an acquired human quality the possession and exercise of which tends to enable us to achieve goods which are internal to practices and the lack of which prevents us from achieving any such goods” (p.191). What virtues are needed for a political leader who is to lead the residents toward a good? While there are many possible answers I would put forth four virtues, namely, prudence, temperance, courage, and charity. These virtues are not evident in the current occupant of the Oval Office. The virtue of prudence points to the qualities of foresight, judiciousness, and carefulness. The travel ban lacked both foresight and judiciousness. Trump’s speeches also reflect a lack of carefulness and instead recklessly promote further division and animosity. The virtue of temperance suggests self-restraint, which is not evident in daily tweets, his attacks on the press who disagree with him, and his demeaning comments about the judiciary. One might say that Trump displays courage, but actually it is more bravado and at times bullying. It takes political courage to face and listen to critics, to admit when one is wrong, and change policies that do not contribute to the common good. Bullies are by their nature not courageous. Charity is the virtue of willing and acting toward another’s good. Trump’s own charity organization, which was under investigation for spending money for political gains, is perhaps most illustrative of his lack of charity in business and in politics. He also clearly evinces a lack of charity in policies aimed at deporting residents, demeaning opponents, publically humiliating persons with disabilities, and violating women. A man without virtues cannot lead people, except through coercion, force, and intimidation.
Can a man who apparently lacks civic virtues possess character? MacIntyre (1984) argues that “A character is an object of regard by the member of the culture generally,” because s/he “morally legitimates a mode of social existence” (p.29). If we use this perspective, Trump does have character. He is regarded by many people in this society, but what mode of social existence does he represent and legitimate? Trump’s character is a caricature of neoliberal capitalism’s production of entrepreneurial subjects; subjects preoccupied with protecting and advancing their own self-interests and seeing individuals as a collection of usable powers or as obstacles to one’s ends. Trump, as an entrepreneurial man, is obsessed with power, prestige, and privilege, which have nothing to do with the common good. Like all caricatures, there is an emptiness or hollowness to his character. There is a dearth of integrity or probity in a caricature, which is evident in the lack of core principles that guide him. To be sure, as a caricature of a market society, Trump does have a principle, which is maintain and furthering his image—an image lacking substance. A character that is a caricature of a market society is not someone who can lead by persuasion and example, except those who are uncritically and thoughtlessly like-minded. A representative democracy must have leaders who exhibit character of substance, of moral principles that can embolden others, not simply the like-minded but opponents as well. A symptom of an illness in the body of the republic is the election of a man who has no virtues and whose character is a caricature of a system that has not moral ethos.
The lack of virtue or character are not grounds for impeachment, which I suspect those who clamor to diagnose Trump as mentally ill are hoping for. In my lifetime I have seen political leaders who lack virtue and who are not mentally ill. The lack of virtue and character are signposts to a trajectory of tragedy, which will take place on a much larger scale. It is unfortunate and sad that the tragedy that awaits Trump will impact the lives of many, most assuredly the less fortunate.
Laing, R. D. (1969). The divided self. New York: Penguin Books.
Lasch, C. (1979). The culture of narcissism. New York: W.W. Norton & Company.
MacIntyre, A. (1984). After virtue: A study in moral theory. Notre Dame, IN: Notre Dame University Press.
Ryan, A. (2012). On politics: A history of political thought. New York: Liveright Publishing.