Should Psychiatrists Speak Out Against Trump?

By Jane Mayer, The New Yorker

21 May 17

The “Goldwater Rule” forbids mental-health professionals to give opinions on public figures they haven’t personally examined. Some may make an exception.

hen Donald Trump accused his predecessor Barack Obama of wiretapping him, James Comey, then the F.B.I. director, told colleagues that he considered Trump to be “outside the realm of normal,” and even “crazy.” Many Americans share this view, but the professionals who are best qualified to make such an assessment have been forced to remain mum.

“I’m struggling not to discuss He-Who-Must-Not-Be-Named,” a psychiatrist named Jerrold Post said last week, speaking on the phone from his office, in Bethesda, Maryland. Post, who is the director of the political-psychology program at George Washington University’s Elliott School of International Affairs, and the founder of the C.I.A.’s Center for the Analysis of Personality and Political Behavior, has made a career of political-personality profiling. However, he is also a distinguished life fellow of the American Psychiatric Association, whose professional code of conduct forbids members to publicly comment on the psyches of living public figures whom they have not personally examined.

The ban, known as “the Goldwater rule,” is the legacy of an embarrassing episode from 1964. That year, Fact magazine published a petition signed by more than a thousand psychiatrists, which declared that Barry Goldwater, who was then the Republican Presidential nominee, was “psychologically unfit to be President.” Goldwater lost the election, but he won a libel suit against the magazine. The bad publicity seriously tarnished the reputation of the profession.

More than fifty years later, Trump appears to be testing the limits of the Goldwater rule. In March, the Washington, D.C., branch of the A.P.A. convened a meeting of its members to debate the rule. Post and several others argued that, given the President’s erratic behavior, the organization was infringing on its members’ freedom of expression. Psychiatrists, they insisted, have a responsibility to serve society at large. “I think there’s a duty to warn,” Post said. “Serious questions have been raised about the temperament and suitability of He-Who-Must-Not-Be-Named.” He added, “It seems unethical to not contribute at this perilous time.”

The psychiatrist John Zinner took the argument further, suggesting that, as doctors, who swear an oath to protect their patients, psychiatrists have an obligation to speak out about the menace posed by Trump’s mental health. “It’s my view that Trump has a narcissistic personality disorder,” Zinner said later. “Trump is deluded and compulsive. He has no conscience.” He said that psychiatrists have a constructive role to play in advising policymakers to add checks on the President’s control over nuclear weapons. “That supersedes the Goldwater rule,” he said. “It’s an existential survival issue.” (There were some dissenters at the meeting. Dr. Mark Komrad, who is on the staff at Johns Hopkins Hospital and Sheppard Pratt Health System, worried that overturning the rule could be bad for the profession. “We’re already seen as peddlers of a liberal world view,” he said. “If we make pronouncements about Donald Trump, nothing is gained. You don’t need a doctor to tell you that the guy on the plane with a hacking cough is sick.”)

Post is part of a push to have the A.P.A. form a commission to revisit the Goldwater rule. He’ll make the argument to a larger audience later this month, at the association’s annual meeting, in San Diego. Meanwhile, the President’s sudden firing of Comey presented an almost irresistible case study.

Post, when asked about the firing, chose his words carefully. He said he agreed with lay commentators that Trump appeared to be trying to suppress the F.B.I.’s investigation into his campaign’s ties to Russia, revealing a pattern—a quickness to get rid of those who disagreed with or threatened him. The result, Post said, would be “a sycophantic leadership circle afraid to question him.” He added that the manner of the firing, which Comey learned about from TV reports, displayed “a failure of judgment in crisis”; it was likely to turn Comey into “a dangerous and resentful witness.” Post said that it reminded him of other leaders he had studied, including Vladimir Putin, “a quintessential narcissist,” whose “way of handling criticism is to eliminate—literally—the critics.” After the Comey episode, Post said, he worried that “He-Who-Must-Not-Be-Named’s leadership is imploding.”

What would Post ask Trump, if he had the opportunity to get the President on his couch? Post cleared his throat and said, “I’m sorry, but I think I’d better not answer that.”

The question reminded him of the time, during a television interview, that Dan Rather asked him what he would do if he encountered Saddam Hussein. Not realizing that the microphone was turned on, Post, who had been discussing Saddam’s “malignant narcissism,” gave a less than scholarly answer: “I would run right out of the office!”