Trump’s mental health valid question
For once, even Daniel Drezner was taken aback. The professor of international politics and prolific online commentator has acquired a minor celebrity as a curator of insider accounts of Donald Trump’s chaos-filled White House, via a series of tweets that begin “I’ll believe that Trump is growing into the presidency when his staff stops talking about him like a toddler.”
But Saturday’s 4,200-word New York Times epic on a day in the life of the U.S. president defeated him. As he explained, most of the stories cited in his Twitter thread “contained only one or two specific instances of the president of the United States displaying the emotional maturity of a fouryear-old. There was never a story so long in detail or quotes that I could not fit it into a single tweet.”
The Times piece, on the other hand, is one long torrent of disturbing anecdotes. If in a familiar vein — the frantic efforts of Trump’s overwhelmed staff to keep him off Twitter, away from bad influences, and in good humour — it adds notable detail to a cumulative account of a president who is not only way out of his depth, but … well, how do you describe a grown man who so closely resembles, in outlook, disposition and comportment, a small child?
This is not a rhetorical question. In recent days, as Trump’s behaviour has seemed to deteriorate further — retweeting antiMuslim propaganda posted by a British far-right party, suggesting that TV commentator Joe Scarborough had murdered his intern — the possibility has been raised with increasing urgency in political and media circles that Trump is, in fact, suffering from some form of mental illness: anything from a personality disorder to progressive dementia.
This has provoked some considerable criticism in its turn, and not only from Trump supporters. The thrust of it has been less to do with the accuracy of the speculation as to whether it was a fit matter to discuss in public. It’s not my purpose here to weigh in on the president’s mental health, but rather to defend the notion that this a permissible line of inquiry.
The first objection has to do with its relevance. What does it matter whether the president is actually unwell: isn’t it enough to know he behaves as if he is? We know that he is a rampant narcissist, a compulsive liar, that he has zero impulse control, does the opposite of whatever he is told, and so on. Who cares whether the explanation for this is clinical, or just bad parenting?
But it is always relevant for a democratic society to understand the motives and thinking of its leaders, if only to anticipate how they will behave in future. To give a small example: there is a competing school of thought that Trump is a strategic genius, his Twitter outbursts revealing not the ramblings of a disordered mind but a talent for changing the subject from whatever other controversy is engulfing his presidency. It is surely important to know which it is.
A second objection holds that lay people, lacking advanced degrees in psychiatry, are not in a position to make such assessments. As a clinical matter, this is obviously true. But in a democracy the public is often called upon to pass judgment on matters that are technically beyond their ken, from monetary policy to foreign affairs. Few of us are practising psychiatrists. But we are able to form common-sense impressions of whether our leaders are entirely right in the head. Indeed, we are obliged to do so.
It is similar to the presumption of innocence. As a matter of courtroom procedure, when the issue is whether to deprive someone of his liberty, it is indispensable: the Crown is rightly held to a high standard of proof, according to stringent rules of evidence. As a matter of public opinion, the bar is rather lower. There is still the obligation of fairness, but we are entitled to draw sensible inferences from the evidence available to us.
An exception might be made, oddly enough, for actual psychiatrists. Decades ago, the American Psychiatric Association formulated what came to be known as “the Goldwater rule” after a group of psychiatrists pronounced on the mental health of the then Republican presidential candidate, Barry Goldwater. It was an abuse, the association advised, to attempt to diagnose someone from afar, without having examined them. We’re all entitled to our opinions, but even experts — especially experts — should not pretend they are more than that.
Attempts to explain Trump’s conduct with reference to mental illness run into a final pair of objections: either that it unfairly stigmatizes the mentally ill or unjustly absolves Trump of responsibility. Both take issue, it seems to me, with an argument that is not being made. No one is suggesting that any form of mental illness is automatically disqualifying for public office — there is a long list of successful leaders who suffered from depression — or that it inevitably manifests itself as bad behaviour. But there are some conditions that are clearly incapacitating, or otherwise intolerable in so critical a job, with the lives of millions at stake.
As for Trump, the situation is reminiscent of when Rob Ford was mayor of Toronto. He was clearly unwell, not just addicted to drugs but haunted by all manner of personal demons (only very late in his term did we learn of the cancer that eventually killed him). As a human being he was of course deserving of compassion and sympathy; he was evidently in need, quite literally, of professional help. And it was the fervent wish of every person of goodwill that he get it — the day he left office.