“Bad behavior is rarely a sign of mental illness”
Kelsey Grammer and David Hyde Pierce on Frasier
Of the many profiles of President Donald Trump over the years, Mark Singer’s classic 1997 feature “Trump Solo” for The New Yorker may be most accurate. It begins with President Trump bemoaning his relationship with the press, saying, “The press portrays me as a wild flamethrower. In actuality, I think I’m much different from that.” It ends with Singer rattling off this perfect number: “(Trump) has aspired to and achieved the ultimate luxury, an existence unmolested by the rumbling of a soul.”
However, even with President Trump’s seeming irrationality and consistent fibbing, his assault on the press, his vitriol toward minorities, (and his apparent lack of a soul), he’s still not suffering from narcissistic personality disorder, says Allen Frances, the man who helped write the definition of NPD for the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). “Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely,” said Frances in a letter to The New York Times.
Frances wrote the letter—not to the public—but rather, to his community after their insistence on diagnosing our commander in chief from their armchairs thousands of miles away from the White House.
A small faction of mental health professionals first wrote an open letter to The New York Times in February, outlining their case for diagnosing Trump’s supposed narcissism, which warps his acceptance of facts—and is now warping ours.
“Mr. Trump’s speech and actions demonstrate an inability to tolerate views different from his own, leading to rage reactions,” Lance Dodes, a retired assistant clinical professor at Harvard Medical School, and Joseph Schachter, a former chairman of the Committee on Research Proposals, write to the The New York Times. “His words and behavior suggest a profound inability to empathize.”
Dodes and Schachter aren’t alone in their quest to diagnose Trump. Maryland psychologist John Gartner, Ph.D., took his rhetoric one step further and started a Change.org petition declaring the president “psychologically incapable of competently discharging the duties of President of the United States.” To date, the petition has acquired more than 26,000 signatures, and it expressly requests Trump’s removal from office using Article III of the 25th Amendment to the Constitution, which states a sitting president should be ousted if he “cannot discharge the duties of the office.”
There are even more theories. A New Republic story wonders if Trump is syphilitic and suffering from neurosyphilis, a condition that manifests itself through “bizarre,” and “volatile behavior,” both of which President Trump seems to have in spades. But does it help to claim that the president is mentally ill?
Frances doesn’t think so. In his letter he raises an excellent point: “It is a stigmatizing insult to the mentally ill (who are mostly well-behaved and well-meaning) to be lumped with Mr. Trump (who is neither).”
David Perry, a journalist who pays particular attention to disability rights, additionally spoke to Upworthy on the dangers of diagnosing from afar, saying, “I get it. … We’re going to speculate. But every person I know who has a mental disability finds that speculation painful, because it suggests that you might expect them to behave like Trump due to their diagnosis.”
Mental illness affects over 43 million adults in the United States in a given year. Let’s not use our distortions around it to diagnose our erratic president. Not only does it uphold the Goldwater rule—a 1973 dictum put in place by the American Psychiatric Association in response to an incident in which the mental health community diagnosed 1964 presidential candidate Barry Goldwater from afar, an ethical breach that could have eroded public confidence in psychiatry—but it stops us from further stigmatizing a group of people who are already massively misunderstood.
Steve Hyman, director of the Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, additionally tells Quartz that mental illness and the treatment of mental illness is a highly nuanced practice, which takes time with the patient to truly understand.
“There are some infectious diseases where categories really work,” Hyman said. “You either have Ebola or you don’t, you have smallpox or you don’t. But most chronic human ills have this continuity with health. So hypertension, diabetes, atherosclerosis. Setting thresholds of illness has a certain arbitrariness to it.”
In the end, we may have to recognize that true resistance to President Trump will come in two places: at the ballot box and in the minds of our representatives.