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Psychoanalysts Raise Ethical Questions by Lifting Ban on Diagnosing Trump

by Countable | 7.26.17

This week the American Psychoanalytic Association (APsaA) sent a letter to its 3,500 members that effectively lifted the "Goldwater Rule," which banned psychiatrists from publicly diagnosing the mental health of public figures who are not under their care.

The APsaA says that it "does not consider political commentary by its individual members an ethical matter," and that “the field of psychoanalysis addresses the full spectrum of human behavior, and we feel that our concepts and understanding are applicable and valuable to understanding a wide range of human behaviors and cultural phenomenon.”

What is The Goldwater rule?

It’s the informal name given to Section 7 of the American Psychiatric Association’s (APA) Principles of Medical Ethics. Section 7 encourages mental health professionals to educate the public about psychiatric matters and current behavior. Sometimes, however, a psychiatrist may be asked about "an individual who is in the light of public attention"—say, a President. Here, the APA is clear that “it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

In summary: if you haven’t treated a person, you have no professional business diagnosing them.

The APA continues to require its members to abide by the Goldwater Rule.

How’d it get its name?

In 1964, Senator Barry Goldwater ran as the Republican nominee for President against Lyndon Johnson. During the contentious campaign, Fact magazine surveyed psychiatrists asking if they believed Goldwater was mentally fit to be POTUS. Fact then ran this cover story:

In the article, The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater," the Presidential nominee was diagnosed as being unfit for office as he suffered from a number of psychological disturbances, including, as the New York Times explained, "paranoia, a grandiose manner and a Godlike self-image. One doctor called him ‘a dangerous lunatic.’”

Goldwater lost the election by a landslide. He sued Fact for libel, winning over half-a-million dollars (adjusted for 2017). A few years later, to prevent the same kind of thing from happening again, the APA adopted the Goldwater Rule.

Why am I hearing about it over 40 years later?

President Donald J. Trump’s unusual behavior has led many people to question his mental health and the comparisons to Goldwater were inevitable.

"We have an ethical responsibility to warn the public about Donald Trump’s dangerous mental illness," said Dr. John Gartner, a psychotherapist who has advised psychiatric residents at John Hopkins Medical School.

Gartner made the remarks in April 2017, during a conference at Yale University. He’s also the founding member of Duty to Warn, an organization of mental health professionals who believe Trump is mentally unfit to serve.

Why’s It Matter?

If Trump was diagnosed as mentally unfit to be President, it could be grounds to enact the 25th Amendment, which states that if the "President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President."

Applying the 25th Amendment to Trump’s mental health would be unprecedented to say the least. Normally, the 25th Amendment is enacted when a president is incapacitated due to an injury or undergoing surgery, and the vice president temporarily becomes the acting president.

We’ll just have to wait and see what the psychoanalysis community has to say about Trump’s mental state.

Do you think mental health professionals should be able to comment on Trump? Or was the Goldwater Rule created for a reason? Hit the Take Action button and let us know your diagnosis of the matter.

—Josh Herman

(Photo credit: Gage Skidmore via Wikipedia/ Creative Commons)

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  • Diane
    07/26/2017
    ···

    All should know by now he is a psychopath which includes narcissistic personality disorder. I'll even give you the definition: According to the Society for the Study of Psychopathy, psychopath traits include: Lack of guilt/remorse Lack of empathy Lack of deep emotional attachments Narcissism Superficial charm Dishonesty Manipulativeness Reckless risk-taking This should all sound familiar. It's time they let the professionals tell the real story in Trump.

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  • Keith
    07/26/2017
    ···

    As someone who works in mental health, I welcome this with open arms. In fact, I'm curious why it is not required that leading members of government get a psychological exam before they even run for office, in the first place. These are the folks that will be in charge of our military, our law enforcement, making laws that effect society, and countless other things, and a sound mental state of mind is not required? According to NAMI, 61 million Americans have a mental health challenge of some sort. That's 1 in 5 people. It is not unreasonable to say that those numbers apply to our leaders as well. When you go to the floor tomorrow, start counting: 1,2,3,4, person with a mental health challenge. 1,2,3,4, person with mental health challenge. That is not to say that those 61 million (1 in 5) people are insane, either. Those challenges include anxiety/depression on up to psychosis or Narcissistic Personality Disorder. And whereas we don't want to discriminate against people with those challenges, we also want to be wise enough to say people with certain challenges (mental illness) should not be making laws. What if a leader is a sociopath, who lacks compassion and a conscience? Sure, they can make really difficult decisions, because they literally do not care one way or another, but when that decision is about the lives of our military? Of protesters in the street? Mental health is so vitally important. I want my leaders to not only be mentally fit, but also to get the help they themselves need. Sometimes that help is in the form of not governmental jobs.

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  • Kathleen
    07/26/2017
    ···

    We need mental health experts to speak out about Trump's lies and distortions. He is regularly trying to ruin the reputation of his opponents with scathing lies. He is a dangerous, inept leader.

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  • Sheila
    07/26/2017
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    It seems that anyone who sees the tweets or hears his disjointed verbiage should question whether that is mentally sound behavior. That much vitriol is also questionable. To say the least someone who can't control his impulses and has nuclear codes should not be in the office of president.

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  • Linda
    07/26/2017
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    We needed this before the election. Since we didn't, let's support this. If the president truly has mental problems, we need to know before he does irreparable harm.

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  • Kodiwodi
    07/26/2017
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    I think it's unethical to diagnose without seeing or speaking to your patient. I also think it is unethical and morally repugnant to allow a man with obvious signs of instability, stress and a family history of dementia to continue to run the country without a comprehension psychiatric exam from a team of non partisan psychiatrists and physicians.

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  • Steve
    07/26/2017
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    This is from the DSM-5 that describes Narcissistic Personality Disorder --- It should feature a photo of TRUMP as a classic case: People with Narcissistic Personality Disorder* have significant problems with their sense of self-worth stemming from a powerful sense of entitlement. This leads them to believe they deserve special treatment, and to assume they have special powers, a re uniquely talented, or that they are especially brilliant or attractive. Their sense of entitlement can lead them to act in ways that fundamentally disregard and disrespect the worth of those around them. People with Narcissistic Personality Disorder are preoccupied with fantasies of unlimited success and power, so much so that they might end up getting lost in their daydreams while they fantasize about their superior intelligence or stunning beauty.

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  • Jeannine
    07/26/2017
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    Trump studied dictators and autocrats and befriends populist and nationalist rulers and wants his chance at a regime he is crazily pushing his boundaries and no one is calling it what it is. He is dangerous, and is slowly destroying everything we as Americans stand for using propaganda and abuse of powers. Soon he will go down some very slippery slopes to completely take over. I wouldn't doubt Putin calls him daily and tells him he wants him to do and say a crazy making thing or take away a small right like the cameras a press then laughs at his control over him. Trump is crazy, his upbringing and. Thug and bully teachings by the people in his life have made him crazy he belongs in an asylum or back in his beloved Russia send him there.

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  • Sherri
    07/26/2017
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    Anyone running for such a powerful office should have to submit to a psychiatric exam as a prerequisite of the job.

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  • Frankie
    07/26/2017
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    At very least he is a megalomaniacal narcissist. That's the nicest I can say about him. Compulsive liar without any trace of a doubt. He won the presidency with a combination of going lower than anyone could of imagined (you can't win an argument with someone who will lie and attack without any integrity), the blood in the water for him was a narrative pushed down the country's throats, 8 years of hate for liberals and Obama frothed up by right wing pundits. He sh*t talked his way to the presidency without any actual credentials or plan for anything he was talking about doing. And now that he is in power and doing nothing that he promised, its us that need the psychological evaluation. We know Trump is crazy but what does that say about us? People voted for him because they hate liberals that much. It's their revenge, and with every new action that is an outrage for the left his supporters cheer louder. The cheering will not last forever.

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  • Sally
    07/26/2017
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    The lies and backstabbing are pathetic

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  • Tricia
    07/27/2017
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    It doesn't matter how batshit crazy he is as long as Republicans in Congress keep telling the emperor how nice his new clothes look...just to use his digits to sign their crap legislation.

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  • Katherine
    07/26/2017
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    Finally! Hopefully this will help implement the 25th Amendment once the Dr's start speaking out.

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  • Jennifer
    07/26/2017
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    As a medical professional-no a psychiatrist- I always hesitate to answer questions about my medical opinion unless I have examined them, their labs etc enough to be certain of a diagnosis. I am not sure that we should lift the Goldwater rule even as I think that Trump IS mentally unfit. I would rather have him be forced by congress to undergo a formal psychiatric evaluation first. If congress is concerned enough to consider a formal article 25 impeachment for mental fitness, then I think it would warrant an objective psych eval be part of that perhaps two evaluations- one by a person picked by president and the other picked by the court or congress. Good luck finding an agreement regarding who that would be.

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  • Bluewitsend
    07/26/2017
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    President Trump's mental Heath should be analyzed. All Presidents should have a physical as well as mental fitness examination before being subjected to the stress and enormous responsibilities associated with being a world leader.

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  • Paul
    07/27/2017
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    The sad part is has anyone taken a serious look at Pence? He is just as big of a nut job as tRump. Research would do you good.

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  • MIKAL
    07/26/2017
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    There is NOTHING to be gained by a "PUBLIC" diagnosis of the President. ONE - it will only FURTHER divide this nation into PRO & ANTI - Trump. Second - It will FURTHER DETRACT from the really important discussions of policy that will affect US. LASTLY (and most importantly) - YOU do not need to have a breathalyzer or blood test to SEE & Smell that someone is DRUNK. Surely, you don't need a SHRINK to tell you that the President acts in ways that most would consider "ABNORMAL" (insert the descriptor you prefer - narcissistic, paranoid, immature, insecure, paranoid... etc.)

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  • Deirdre
    07/26/2017
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    Let the professionals speak their mind. They would know who is mentally ill. And I agree with them that trump is mentally ill.

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  • Karen
    07/26/2017
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    There is something wrong with Trump. The fact that his mind changes in the blink of an eye is a problem for public safety. Since his own team nor the Republican Party at large are able or willing to address his dangerous behavior, perhaps outside forces need to weigh in.

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  • David
    07/27/2017
    ···

    Read Nicholson Baker's book "Human Smoke: The Beginning of World War II, The End of Civilization" -- a fascinating compendium of primary sources documenting Hitler's deadly ascendancy and, thus, in the present context, a warning about the deadly consequences of not speaking out about the dangers of untreated mental illness. Those with professional knowledge must speak up and tell the truth. The parallels between interwar Germany and post Obama America are terrifying.

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