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An Eye on the White House


July 26, 2017

Why Psychiatrists Can’t Pick Apart Trump’s Psychology

The world’s largest psychiatric association does not let its members comment on the President’s mental state.

Presidential politics is always personal.

It’s not to say the issues don’t matter. Health care, civil rights, the economy, and war are always at the top of the agenda in debates and interviews. But increasingly, the candidates themselves have become issues as contentious as any other.

This was never truer than in the 2016 Presidential race, where Donald Trump dominated media coverage with his exaggerations and unfiltered rhetoric. This has lead some on both sides of the political aisle to wonder just what’s going on inside his head.

Trump isn’t the first candidate to face accusations of being unfit to lead. When John McCain ran in 2008, commentators pointed to his advanced age as a liability (especially since it put Sarah Palin a “heartbeat away” from the office). Obama was accused of being born on foreign soil. Critics said Mitt Romney was too wrapped up in business dealings.

But President Trump is the first candidate in a long time to face questions regarding his mental health.

In the 1972 election, democrat George McGovern chose Thomas Eagleton as his running mate. McGovern was unaware that Eagleton had previous been hospitalized for depression. When he found out, he initially promised to back Eagleton “1,000 percent”, but later consulted with psychiatrists and doctors regarding his would-be vice president. He asked Eagleton to resign, and Eagleton abided.

Further back, in 1964, the press turned its guns on Republican Barry Goldwater. The poorly-named Fact magazine published an article claiming that 1,189 psychiatrists stated Goldwater was unfit to be president due to his mental state. In truth, the claim was misleading at best; the magazine had polled 10,000 psychiatrists, only 2,417 of whom applied, and the majority did not see Goldwater as unfit.

Goldwater lost the election, but he also filed a libel lawsuit against the magazine. Following this incident, the American Psychiatric Association (APA) put in place the “Goldwater Rule”, which reads as follows in the Principles of Medical Ethics:

On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, 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 brief, it meant members of the association cannot offer opinions on someone they have not personally evaluated.

In March of 2017, the Washington D.C. branch of the APA debated the rule. Some argued the rule infringed on freedom of expression. One psychiatrist, John Zinner, argued psychiatrists have an obligation to speak out on the issue, just as doctors swear an oath to protect their patients. But not all agreed the rule was obsolete. Mark Komrad worried overturning the rule would turn the public against their profession, which is “already seen as peddlers of a liberal world view.”

Recently, the American Psychoanalytical Association announced it would allow its 3,000 members to comment on Donald Trump’s mental state as they pleased. Many commentators are touting this as a huge change, but the Psychoanalytical group is miniscule compared to the American Psychiatric Association, which boasts over 36,000 professionals in its ranks.

The latter group reaffirmed its commitment to the Goldwater Rule in March.