Donald Trump has reached the age of 70, raised a successful functional family, does not smoke, drink or have a substance abuse problem, and is a billiionaire [sic]. He has arguably met the criteria for stable function in the most cosmopolitan society = New York City. he [sic] has excelled at what he does. We should all have such a mental illness. it certainly is adaptive!
I’ve always seen Vox as a particularly malign influence on the world, because it has mastered the art of using faux-objectivity to push highly partisan views. This article exemplifies that: it brings in a psychiatrist from Yale SOM(!) to make a long series of reasonable-sounding statements that guide the reader to thinking that we should forcibly detain Trump for a mental health examination. The article’s cocktail of appeals to authority and progressive talking points guarantee that nonexpert readers will happily follow Lee to her conclusion.
Now, I’m a lowly fourth-year medical student at an institution with no particular claim to fame, so I’m not here to discuss diagnoses in psychiatry (my intended field) with anyone. Fortunately, we don’t need to talk about that. Simple common sense will suffice for this matter.
Lee begins the interview by arguing that Trump is entering a “mental health crisis,” as evidenced by “denying his own voice” on the Access Hollywood tapes, as well as the “sheer frequency of his Tweets,” including various “anti-Muslim videos.” She then calls for “an emergency evaluation [to] be done.”
To be clear, involuntary detention for emergency evaluation (a “Baker Act” in lay terms) can only be ordered for people likely to become injurious to themselves or others if not detained. For example, the relevant law for Washington D.C. states:
An accredited officer or agent of the Department of Mental Health of the District of Columbia, or an officer authorized to make arrests in the District of Columbia, or a physician or qualified psychologist of the person in question, who has reason to believe that a person is mentally ill and, because of the illness, is likely to injure himself or others if he is not immediately detained may, without a warrant, take the person into custody, transport him to a public or private hospital, or to the Department, and make application for his admission thereto for purposes of emergency observation and diagnosis. The application shall reveal the circumstances under which the person was taken into custody and the reasons therefor.
Being in a “mental health crisis” (whatever that even means), or “denying his own voice,” or high frequency tweeting, is thus irrelevant for the purposes of the law. Even less relevant is “laying a foundation for a violent culture,” or moving the American embassy in Israel to Jerusalem.
And I will be blunt here: vis-a-vis psychiatry, it does not matter one iota what Trump says in a political context. Bolsonaro, Adityanath, and Duterte make Trump look quiet and genteel in comparison. That may be off-putting to Lee and Barclay, but the political world is a coarse and ugly place. Becoming coarser and uglier is a sign of adaptation, not pathology.
Lee seems to think that a foreign policy (possibly) leading to violence is enough to override such objections. This is odd, because I was not aware that involuntary detention laws, designed to deal with men announcing suicidal/homicidal intent or neglecting themselves into utter squalor, were actually applicable to geopolitical brinkmanship or foreign interventionism. Indeed, if we were to use the latter as criteria for detention, we could quite literally detain every single American president since at least 1945.
In her next response, Lee claims that
It would be hard to find a single psychiatrist, no matter of what political affiliation, who could confidently say Trump is not dangerous.
Since this cannot be proven or disproven, there’s nothing to say. What’s more interesting is what comes next.
I am sure there are some who feel unsure…and that is fine, since not everyone has devoted her 20-year career to studying, predicting, and preventing violence like I have.
This should be raising red flags in everyone’s mind. It wasn’t too long ago that “Dr. Death” made similar claims of his ability to predict future violence, often without even examining the patient, just as Lee has not examined Trump.
The psychiatric establishment considered his opinions little more than quackery. Paul Appelbaum, a University of Massachusetts psychiatry professor whose complaints ultimately led the APA to expel Grigson, complained that future behavior went well beyond what science can purport to know.
Psychiatry’s skill in predicting specific future behavior is unrelentingly poor. And it would be even worse when we realize that political expedience is muddying the waters of how we see Trump.
Indeed, Lee did not once raise the possibility that Trump may be acting how he acts for the sake of political advantage. This is odd, given that Trump has been a global media presence for decades, and he made a name for himself in the primary by being the man who rallies his base by doubling down instead of backing down. I would assume that “secondary gain” would be at the top of the proverbial differential for someone seeking to make sense of Trump’s actions, but it doesn’t seem to even enter Lee’s mind.
The remainder of the piece largely reiterates the first response and details the logistics of Lee’s future plans. The main item of interest is how many people are involved in this plot, and just how much groupthink is going on here.
It’s not surprising, given that psychiatry and the law are overwhelmingly Left-leaning professions, and political homogeneity engenders groupthink. But it has to stop, for our own interest if nothing else. Of all fields in medicine, psychiatry has always been treated with the most public suspicion. It does not help us if we take sides on viciously partisan issues with dubious (at best) legal or scientific backing for our actions. All that will happen is that we hemorrhage whatever good will the public previously had for us.