Faculty & Staff / Social Justice

We Don’t Need to Diagnose Trump to Say He’s Wrong

Fitzgerald_154x154Paul Fitzgerald, Psy.D., LCPC, NCC, is a core faculty member and Director of Training for several master’s counseling programs at Adler University in Chicago. He is also a licensed clinical psychologist with special focus on employee assistance programs and industrial and organizational psychology.

With psychologists publicly psychoanalyzing and diagnosing presidential candidate Donald Trump, the American Psychiatric Association felt compelled to remind mental health clinicians of The Goldwater Rule. It’s a warning against commenting on the mental health or trying, in general, to diagnose someone in the public eye.

There are good reasons for this. One is that it’s simply unethical. Diagnosis is a medical activity that should only be done in the context of a helping or healing relationship, and for a helpful purpose.

Perhaps more important is that through such public use of clinical diagnostic terms, the terms often come to be used as insults and do more to stigmatize people who suffer from mental illness. And, no one with an established diagnosis should be implicitly likened, in this case, to a man generally known for making racist and misogynist insults, inciting violence against political opponents, and intentionally spreading false information.

But is it not appropriate to speculate on the fitness of an individual to perform the duties which she or he may be called upon to perform in an elected office? After all, police officers and others with a high degree of accountability to the public must submit to psychological testing and fitness-for-duty evaluations. Why not require the same degree of scrutiny for individuals seeking the most powerful position in the nation, and arguably, the modern world?

I think it’s perfectly acceptable for writers, biographers, journalists, and members of the general public to use a public figure’s speeches, writings, media appearances, and social media posts to draw inferences about the individual’s core convictions, beliefs, attitudes, values, and personality.

When it comes to Mr. Trump, “authoritarian” is one of the most common adjectives used to describe his personality. He espouses the qualities of winning and being strong, as opposed to cooperating, empathizing, and seeing others as equals. Unsurprisingly, his supporters cheer for these sentiments.

Trump supporters are said to operate on fear, resentment, and a sort of willful ignorance, rather than on cooperation with the “ironclad logic of social living” that Alfred Adler described. In a time of economic insecurity, even a person with a healthy sense of belonging and cooperation can be stirred into a state of fear and hate—the mob mentality that allowed Hitler and other despots to gain power.

In recent weeks, many psychotherapists (myself included) have joined in signing a “manifesto” that calls for our society and our social sciences to address the problems of authoritarianism and intolerant thinking among our voting public, with consideration of their effects on society. Although the manifesto describes this ideology as “Trumpism,” it is not limited to Donald Trump or his supporters.

The resurgence of former KKK figure David Duke, the popularity of Sheriff Joe Arpaio in Arizona, anti-Muslim hate speech and crimes, church burnings, and the stereotyping of African-Americans as “thugs” and “welfare queens” show that these trends were strong well before Trump seized on these fears, resentments, and simplistic beliefs, and rode them to the nomination of one of our two major political parties.

So what are we left with as mental health professionals concerned about the directions our society is taking? Fortunately, Adler gave us a very clear example of how we can use our knowledge and understanding of people in clinical settings to address social problems. We are not merely social scientists, who analyze these trends dispassionately. We are healers, who try to help people. That applies to nations and societies as well as to individuals and families.

We can use Adler’s and Rudolf Dreikurs’ principles as a guide. They taught us that social feelings, cooperation, and equality are not just nice things to praise; they are survival skills. Our future, our planet, and our civilization depends on our ability to provide all human beings with the opportunity to grow and develop this sense of belonging.

If people are mistreated, marginalized, and excluded, this damages not only the victims of such treatment, but the perpetrators as well. Cravings for power, adulation, revenge for perceived slights, and avoidance of the hard work of cooperation are all the hallmarks of the discouraged child in Dreikurs’ view. They are also hallmarks of a sick and discouraged society as well.

Therefore, we can point out the “basic mistakes” of Trump’s ideology and that of his supporters, without inappropriately engaging in clinical diagnosis. We can identify and call out mistaken, self-defeating, and socially useless attitudes, and urge people of conscience to oppose them whenever they come into our public discourse. We do not need to keep quiet about other people’s opinions when those opinions run counter to the principles of psychological health and social progress.

We can be the voice of sanity without calling anyone else insane.

  • Hal brown

    As the therapist who thought that Trump represented a unique situation where the usual Goldwater Rule could be suspended I have been banned from even bringing this up on the Citizen Therapists Facebook page. Considering that this is a private group I am offended that debate about this has been closed. I simply disagree with you and the large majority of the therapist who responded to the poll I pit there. But isn’t it possible that I am correct for the reasons I have written about in several essays I put on Daily Kos? For example: http://www.dailykos.com/story/2016/08/13/1559763/-The-Ethics-of-Diagnosing-Trump-Part-Two
    http://www.dailykos.com/story/2016/08/03/1556196/-The-media-finally-recognizes-what-shrinks-knew-a-long-time-ago-Trump-is-pathological

    http://www.dailykos.com/story/2016/06/17/1539678/-Ethics-Shrinks-and-Trump-Should-they-speak-out

    • FitzgeraldCounseling

      Hal, I am not really disagreeing with you… I’m not convinced that a ban on commenting on an candidate’s mental health is ethically required or always a good idea, either. Unlike the American Psychiatric Association, the American Psychological Association has never made such a prohibition. The Ethical Code says that we should refrain from implying that we have a professional relationship when we do not:

      5.04 Media Presentations
      When psychologists provide public advice or comment via print, Internet or other electronic transmission, they take precautions to ensure that statements (1) are based on their professional knowledge, training or experience in accord with appropriate psychological literature and practice; (2) are otherwise consistent with this Ethics Code; and (3) do not indicate that a professional relationship has been established with the recipient. (See also Standard 2.04, Bases for Scientific and Professional Judgments.)

      I take this primarily to mean we shouldn’t give advice over the radio or TV (We could call it the “Joyce Brothers Rule,” since she was expelled from the APA for doing that kind of thing); but it could also apply to comments about a public figure. We should probably limit ourselves to saying that a person’s public utterances reflect characteristics or signs of a problem (such as paranoid thinking or grandiosity), but unless we say that we have a relationship with a person, it would not make sense to claim that we can speak to the presence of a disorder. At least, that’s my take.

      I would think we could also comment on the Freudian implications of the size and shape of Trump Tower as well, but I decided that the Citizen Therapists Facebook page may not be the best place for that kind of tongue-in-cheek “interpretation.”

      As far as the ban put in place on the Citizen Therapists group, it’s Bill Doherty’s group and his website, and as the moderator, he gets to set the rules for dialogue posted there. I personally think it’s difficult to speak to the pathology of a group of people (as Bill Doherty wishes to do) without including some reference to the pathology of a figure who commands such a high degree of their loyalty. But if he wants to control the discussion to that end, I will respect his wishes. We have many other social media outlets (like this blog) where we can debate these issues in a healthy way.

      This whole question reminds me of an article I read many years ago in the American Counseling Association’s flagship journal (Journal of Counseling and Development) which posited that we should treat racism as a disease. I personally did not see the point of that, especially since their suggested solution (mandatory consciousness-changing group therapy) was highly unpalatable to me. But the whole question highlights the thorny issue of what is “normal” and what is pathological, when we are talking about widespread yet socially useless tendencies. My Adlerian training gives me direction and sound guidance on the question: As a rule, beliefs and values that are shared by the community tend to be healthier ones. But there are exceptions (as Adler and Dreikurs knew all too well from the Nazis): If a large group of people share a socially useless belief, it can be considered pathological. Adler used the term “fanaticism” for this, and he seemed to relate it to the idea that when people place ideas or beliefs above the well-being of their fellow humans, they are behaving in a pathological manner.

      Thanks for your comment; it was very thought-provoking.