Donald Trump is unlike any other president in US history. The country has had its share of stupid presidents, impulsive presidents, lying presidents, ignorant presidents, narcissistic presidents, bellicose presidents and unpredictable presidents.
But never before has one so fully embodied all these undesirable traits. And never before have the institutions of US democracy appeared so fragile in the face of autocratic attack.
Not surprisingly, Trump鈥檚 radical policies, strange behaviour and unusual leadership style have inspired fierce political opposition. What is a surprise is that they have become the source of widespread armchair psychiatric diagnosis (focused on the erroneous claim that he has ) and analysis of his psychology (is he consciously lying or does he believe his own lies).
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This started with political commentators and comedians, but soon spread to mental health professionals, who felt compelled, in the national interest, to disregard the usual ethical constraints against plying their trade from afar with public figures.
Several petitions have been started. One, with , states: 鈥淲e, the undersigned mental health professionals (please state your degree), believe in our professional judgment that Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States. And we respectfully request he be removed from office, according to article 3 of the 25th amendment to the Constitution, which states that the president will be replaced if he is 鈥榰nable to discharge the powers and duties of his office鈥�.鈥�
There was also a this week in a similar vein, signed by 35 psychiatrists, psychologists and social workers.
World-class narcissist
I strongly oppose these initiatives for several reasons. But the main one is the inaccuracy of the narcissistic personality disorder (NPD) diagnosis: Trump may be a world-class narcissist, but this doesn鈥檛 make him mentally ill.
I wrote the criteria for NPD for the Diagnostic and Statistical Manual of Mental Disorders, which guides mental health diagnosis in the US and beyond. These require not only that the personality features be present, but also that they cause clinically significant distress and impairment. Trump appears to cause severe distress in others (rather than experiencing it himself) and has been richly rewarded (rather than punished) for his self-promoting and self-absorbed behaviours.
It also unfairly stigmatises people with mental illness (who are mostly well behaved and well meaning) to be lumped with Trump (who is neither) and it is an insult to the dignity of their sometimes deep suffering to compare it with his petulant tantrums and petty disappointments.
We must avoid the frequent mistake of confusing mental illness with bad behaviour. Most people who lie, cheat and exploit others are not mentally ill, and most mentally ill people do not commit dishonourable acts.
Armchair diagnosis
What鈥檚 more, psychiatric diagnosis is already done far too casually and inaccurately in medical and mental health practice. Armchair diagnosis further cheapens its currency.
Trying to impeach Trump or remove him from office on medical grounds is a terrible idea. Those next in line support the same dangerous, science-denying irrationality, but in a more palatable form likely to stimulate less-effective opposition.
I am sure the mental health petitioners mean well. I fully share their alarm that such a flawed man has the power to degrade our world鈥檚 future. Trump must be tamed, but it won鈥檛 be done from a mental health pulpit.
Psychiatric name-calling is a misguided way of countering the president鈥檚 attack on democracy. Trump鈥檚 clear and present threat to peace, the global climate, rational thought and science must be met with political tools, not misapplied psychological ones.
