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The Dangerous Case of Donald Trump

Written Wednesday, December 6, 2017

The twenty-seven prominent psychiatrists and mental health experts who contribute essays to the book "The Dangerous Case of Donald Trump" edited by Bandy X. Lee, MD, MDIV, are fully aware of the prohibition called the "Goldwater rule" but seem to have found a way around it.

The "Goldwater rule," adopted by the American Psychiatric Association in 1973, says, "It is unethical for a psychiatrist to offer a professional opinion [of a person] unless he or she has conducted an examination." The ethics code of the American Psychological Association similarly states "psychologists should not offer a diagnosis in the media of a living public figure they have not examined." 

So what are mental health experts to do who have studied and experienced working with people who suffer everything in the book--the "Diagnostic and Statistical Manual"? Most observations made by the mental health experts in "The Dangerous Case of Donald Trump" are not based on opinion but originate in Trump's own written, audio, and/or video records as he tweets, speaks, and acts. 

Confidentiality is the hallmark of the psychiatrist/psychotherapist's relationship with his or her patient/client. But also sacrosanct is the professional's duty to protect or warn when someone poses a danger to himself or to others. Recognition of that duty is what motivated the experts to contribute their essays to "The Dangerous Case of Donald Trump."

But psychiatrist and part-time associate professor of psychiatry at Harvard Medical School, Leonard L. Glass considers the duty to warn "metaphoric--that is, we professionals can 'connect the dots' and alert the citizens possessed of a particular expertise; not as clinicians who are responsible for preventing predictable violence from someone under our care." 

James Gilligan, former medical director of the Bridgewater State Hospital for the criminally insane and director of mental health for the Massachusetts prison system, author of "Violence: Our Deadly Epidemic and Its Causes," and presently clinical professor of psychiatry at New York University, cites the German Psychiatric Association of the 1930s as not deserving "any honor or credit for remaining silent during Hitler's rise to power." He sees the oganization as an enabler of the worst atrocities Hitler committed--as were" he adds, "most German clergymen, professors, lawyers, judges, physicians, journalists, and other professionals and intellectuals who could have, but did not, speak out" against Hitler.

Gilligan does not equate Trump with Hitler. "The issue we are raising," he says, "is not whether Trump is mentally ill. It is whether he is dangerous." 

Edwin B. Fisher, Ph.D., a clinical psychologist and professor in the Gillings School of Global Public Health at UNC-Chapel Hill, reminds us of President Kennedy's ability to successfully negotiate with Premier Nikita Khrushchev on the crisis in 1962 when Russian nuclear missiles stockpiled in Cuba were aimed at the US. He says in his review of "Deterrent or Defense," Kennedy favored the stance of its author the British military analyst Basil Liddell Hart: "Keep strong, if possible. In any case, keep cool. Have unlimited patience. Never corner an opponent and always assist him to save face. Put yourself in his shoes--so as to see things through his eyes."

Compare Kennedy's attitude to that of President Trump. Last August while at his golf club in New Jersey, the president interrupted his vacation to tell reporters, "North Korea best not make any more threats to the United States. They will be met with fire and fury like the world has never seen." 

According to the New York Times, North Korea responded that it was "considering a strike that would create 'an enveloping fire' around Guam, the western Pacific island where the United States operates a critical Air Force base." 

Speaking to the General Assembly of the United Nations in September, Trump said, "If the US is forced to defend itself or its allies, we will have no choice but to totally destroy North Korea. "Rocket man" (as Trump named North Korea's leader Kim Jung Un) is on a suicide mission for himself and his regime." 

By November Trump's "Rocket Man" had devolved into "Little Rocket Man" in an aside the president made during his speech about tax reform at an event in St. Charles, Missouri, adding that Kim Jung Un is a "sick puppy." LIke children arguing, the North Korean govenment called Trump "an old lunatic, mean trickster and human reject" to which Trump replied that Kim was "short and fat." Only children aren't usually armed with nuclear weapons.

During an interview with MSNBC's Chris Matthews, Donald Trump himself, when he was still a presidential candidate, posed a question: "Somebody hits us within ISIS, you wouldn't fight back with a nuke?" When Matthews responded that nobody wants to hear a man running for president talk about using nuclear weapons, Trump asked, "Then why are we making them?" 

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