Amid the Violence, Sickness and Economic Collapse, the Psychiatric Establishment Still Ignores the Mental Health Emergency in the Oval Office
A nation most afflicted with a mental health problem is the least likely to address it. I am speaking of the mental health, or lack thereof, of the president.
His psychological impairments have been deadly through action and inaction. They are promoting violence through pronouncements such as, “When the looting starts, the shooting starts.” Donald Trump calls protesters “thugs.”
It is an uncomfortable fact that needs to be stated: The president’s psychological dangers have resulted in tens of thousands more deaths, with still no end in sight. Trump is responsible for the coronavirus lockdown and the economic collapse.
That the mental health field has been silent is unconscionable; there is no way around it.
If the people cannot count on health professionals to stand up for human safety and survival to whom can they turn?
Our ethics code explicitly states that physicians have a “responsibility to patients … as well as to society.” That a prominent psychiatric association has campaigned not just to protect a public figure over public safety but stopped independent mental health professionals from trying to fulfill their societal duty should be the scandal of our era.
A psychologically dangerous president has provoked social, cultural, public health and now civic dangers.
We know from the pandemic that the exclusion of expert ideas can be a death pact. Mental health is no exception.
Now, with a nation in flames, we cannot pretend it was unknowable. Mental health professionals do not just diagnose illness. We assess signs of psychological danger, and warn and protect potential victims including the public. That is our most primary duty.
By the time violence erupts, there has usually been a long process leading up to it.
Trump did not invent racism, nor generate the pandemic. But, as we anticipated, a psychologically dangerous president has provoked social, cultural, public health and now civic dangers.
Human beings are symbolic creatures, and the office of the president carries great symbolism. A president who lacks respect for life—even disdains it—will give aid and comfort not just to racists but to white supremacist terrorists who are in truth more anti-life than pro-white.
OK with Police Brutality
- tried to revive the death penalty for the wrongly accused “Central Park Five”
- called white nationalists after a murder in Charlottesville, “very fine people”
- derided athletes who respectfully knelt to honor blacks who died from brutality as “sons of bitches”
- remained silent about a police officer who murdered with his knee
He is also the president who will give permission to police brutality as he threatens protesters with “vicious dogs” and “ominous weapons.”
This occurred after he contributed to grievances:
- by allowing disproportionate COVID-19 deaths among minorities
- by invoking the Defense Production Act to force minority workers to their deaths
- by allowing big businesses to profiteer off the pandemic while leaving minorities especially defenseless against layoffs and evictions.
These are not coincidences but a deep-seated pattern that is already intensifying in the face of an unrealistic re-election campaign. Trump has exercised deployment of the National Guard as well as the targeting of journalists. Autocrats often use such tracks to steal elections.
Longing for Love
Individuals who lack empathy or conscience often exhibit cruelty or even pleasure at others’ suffering and death. They are commonly consumed with envy or vindictiveness at a world in which they cannot take part.
They are, as psychopathy expert Dr. Elizabeth Howell calls them, “outsiders to love.”
I have written that violence is a longing for love gone awry: When one is deprived of love, one does not become neutral to it but develops psychological defenses that make the dearth more endurable.
In the process, however, one rejects love, life and ultimately humanity itself. Substituting respect for love, and fear for respect, if one can have neither respect nor love, the focus turns to subjugation through violence and fear.
This is why experts cautioned against Trump holding onto war-making powers and access to nuclear weapons.
There is no excuse for the professionals who encounter numerous Donald Trumps through the course of their careers and yet choose to remain silent.
That the dangers were occurring in the political sphere is not a valid excuse when the combination of personality and political power produces the toxic mix.
A Misguided Psychiatric Association
In this context, I would like to urge the mental health field—especially psychiatry—to meet its societal responsibility.
Through my 25-year career, I have greatly valued the mental health knowledge I have been able to impart to my students at Yale Law School. I have also valued being able to contribute a psychiatric perspective to the World Health Organization’s violence prevention division.
However, a self-image problem seems to be afflicting psychiatry.
Low self-esteem in an individual can lead to a failure to stand up for one’s beliefs.
The same in a field can result in a failure to represent justly its own principles of ethics and practice.
It easily can be pulled into corruption, such as it has with the pharmaceutical industry. That was my reason for resigning from the American Psychiatric Association in 2007.
More recently, to my great dismay, the APA wrongly protected an impaired president to preserve its federal funding.
Some members of my field may cite principle, emphasizing the need to avoid “ad hominem attacks,” and I would generally agree. But medical identification is not an “attack.” The issue at hand is protecting public health and safety, not a formula for keeping oneself in the good graces of power.
If not psychiatrists, who will connect the dots to dangerous psychopathology in the president?
If not mental health, who will have the language to address the colossal elephant in the nation’s room?
If not the experts, who will break the stigma and misconceptions and bring to bear the practical knowledge of dealing with this natural phenomenon?
In the office of the presidency, this common occurrence has turned into what I have called democide (government killing of citizens), genocide, bioterrorism and now a death wish, while meeting all criteria for each.
It is an issue we can no longer afford to avoid.