Attack Trump’s politics, not his mental health

Donald Trump. I want to bleach my fingers just for typing his name. With every day, the global anger at his ineptitude and wilful immorality grows.

And yet, a certain group of his detractors fill me with almost as much exasperation. Namely, those who want to label him mentally ill.

I think I understand them. It’s a natural reaction to try to reject Trump with every fibre of your being. It would be unbearable to stand by and let him play at nuclear war, fail to denounce hatred, and wantonly insult every last honourable human being, all while making a personal profit into the bargain. So we use every tool we have to denounce him.

But calling him mentally ill won’t be effective, and will only make the world an even tougher place for our children to grow up in. I will tell you why.

Almost every ‘professional’ who claims to have adequately assessed Trump’s mental state (without meeting him, interviewing him, or reading his medical notes) says he has the same thing – narcissistic personality disorder (NPD). Aside from highlighting the hugely dubious nature of diagnosing someone from a distance, the label of NPD would add nothing but a name to Trump’s manner of being. Unlike other mental health diagnoses that might offer insight into some underlying neurological disturbance or future risk of deterioration, all NPD does is describe what someone is like as a person.

But people already know Trump. They had an intimate and excruciatingly long introduction to his personality during the presidential campaign. They watched his vile, obnoxious, self-serving, callous, dismissive behaviour, and his admissions of sexual assault. And then they voted for him. To deem him medically unfit for office now, based solely on the same information that voters saw and decided was fitness for office, would be to give doctors more power than history teaches us that they should have. I am reminded of Russian dissidents being diagnosed with ‘sluggish schizophrenia’ on little more evidence than unorthodox political views, and carted off to the uranium mines.

And this is crux of the matter. Diagnosing someone as mentally ill is meant to be the first step in encouraging them to get help, to feel better, to improve their life. Even for someone whose condition primarily causes them to hurt others, like antisocial personality disorder, it’s a prelude to breaking the cycle of prison sentences and starting some rehabilitation, for that person’s benefit. It’s a tool for good. But Trump is President of the United States of America. Almost by definition, he couldn’t have done better for himself. Where is his need for help?

Those aiming to diagnose Trump as mentally ill want to use that label not as a means to help him, but as a weapon, to cost him his position. They image him being dragged from the Oval Office, kicking and screaming, straightjacket and all. But as much as I’d love him to be removed, what would that particular scenario say? It would say, if you have a mental illness, you shouldn’t run for office. That’s not the kind of world we are meant to be fighting for. Mental illness should entitle you to sympathy and understanding, treatment, time off and gradual return to work, not severance of your contract to the sound of a joyful crowd.

If you want Trump out of office – and as a human being, you should ­– then I will offer you another interpretation.

That he is an arsehole. No need for talk of mental illness, no reason to Google lists of symptoms, pretend you’re a psychiatrist and root through amendments of the Constitution. Just a pure and concentrated opinion that he is a fundamentally shit person.

Work on getting him out the same way he got in. Politically. Attack his policies, attack his diplomacy, attack his public relations, attack him as a person. Just don’t make mental illness your choice of weapon; it will only injure others who may do a better job.

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About Alex Langford
I am a psychiatrist (now an SpR) based in Oxford after 3 years working in South East London. Before I went into psychiatry, I used to be a general medical doctor, and I also have a BSc in psychology. I'm particularly interested in improving the public face of psychiatry, evidence based medicine, teaching and patient rights. Don't mention cricket unless you've got the next fortnight free to discuss it.

4 Responses to Attack Trump’s politics, not his mental health

  1. zanyzigzag says:

    This is an excellent argument and your points are clear and well-made. I think your point about diagnosis being used as weapon rather than to help is particularly important. Thank you for sharing your thoughts on this issue.

  2. Aileen Obrien says:

    Dear Alex
    I’m on editorial board of BJP and am commissioning a debate about this issue. If you are interested could you email me ?
    Aileen O’Brien

  3. Well said. I have a similar view. I suspect many of our colleagues do as well. But the press, and its readers, prefer the outspoken and scandalous.

  4. Sorry, I apparently mistyped the internal link.

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