Subtitles section Play video Print subtitles That is an awkward question, but it's one that's being asked on every major news network in America. President Trump's fitness for office is now the top story in the country. Reports suggest that even Trump's advisers are worried about it. Everyone around the president questions his intelligence and fitness for office. 100 percent of the people around him. Concerns have gotten so bad that Trump agreed to be screened for dementia as part of his last health exam. None of this has to do with Trump's political positions. They have to do with his ability to understand the world around him and make good decisions. Everybody wants to know: is this president of sound mind? And if talking about this kind of thing makes you uncomfortable, wait 'til you see how much it's stressing out actual mental health experts. In a series of tweets, the president insisted that he is "like really smart" and a "very stable genius." Last October, a group of 27 mental health experts published this book: The Dangerous Case of Donald Trump. In it, they warn that Trump's behavior shows him to be dangerously unstable, describing him as a pathological narcissist who's delusional, suffers from paranoid ideation, lacks conscience and empathy, and exhibits a host of destructive and dangerous psychiatric symptoms. Yeah, it's rough. Two months after its publishing, the book's editor met with 12 US senators to talk about Trump's mental fitness. That editor's name? Dr. Bandy Lee. I am a forensic psychiatrist at Yale School of Medicine and an internationally recognized expert on violence. Since the book came out, Dr. Lee has become kind of the face of mental health experts warning about Trump. We express our consensus view that Some of the psychological signs are: All of these are highly associated with violence. One thing I noticed is that she starts almost every interview about Trump by saying this: I'd like to make clear that I speak for myself She did it in our interview too. That's because what Dr. Lee and her colleagues are doing, discussing the mental health of a politician who isn't their patient, is pretty controversial. And to understand why, we have to go back to 1964. Don't tune out. I'll make this quick. Back then, Republican Sen. Barry Goldwater was running for president. He was a far-right candidate who talked openly about wanting to use nuclear weapons and was endorsed by the KKK. I know, time is a flat circle. In response to Goldwater's candidacy, Fact Magazine published this piece, in which over 1,000 psychiatrists argued that he was psychologically unfit to be president. Goldwater lost the election, but he sued the magazine's publisher for libel and won, causing the magazine to shut down. In response, the American Psychiatric Association created this guideline, which states that when it comes to public figures, it is unethical for psychiatrists to offer a professional opinion unless they've conducted an examination on that person. They called it: the Goldwater Rule. Well, I was going to say it. But yeah, the Goldwater Rule. Which brings us back to this book. Lee and her colleagues argue that they're not violating the Goldwater Rule because We're not interested in making a diagnosis. They're assessing how dangerous he might be based on his public behavior. Most of the information that you get about dangerousness comes from observation of their behavior, watching their interactions with people, assessing them in real situations, reports of how they respond, objective signs that we can still evaluate even if it's not enough to make a diagnosis. But in March, the APA expanded the Goldwater Rule, clarifying that rendering any professional opinion about a public figure's affect, behavior, speech, or other presentation is unethical. In other words, unless Trump agrees to a full mental health screening — never going to happen — tons of psychiatrists are basically barred from commenting on his mental health. And that is very alarming to me. Many people call it a gag rule. Gag rule, I'm into it. You would be. That gag rule has a big impact on how the media talks about Trump's mental fitness. Lee worries that if they can't talk to mental health experts, journalists are more likely to normalize Trump's abnormal behavior. Most people are not used to seeing impaired individuals day in and day out, so It's tough to grapple with the possibility that the person in charge of our nuclear arsenal might be deeply unstable. So instead, our brains look for other explanations for Trump's behavior. I want to believe he's just dishonest, not delusional. Trump peddles conspiracy theories about Obama's birth certificate, and he's just playing to his base. Is there some strategy in bringing up the Obama birth certificate thing again? Trump is not delusional. He's being very politically savvy. What should be evidence of a serious emergency gets downplayed as just Trump being Trump. Donald Trump's a different type of guy. I mean, he operates differently. That difference has made him very successful. One of Lee's colleagues has a great name for this phenomenon. He calls it "malignant normality." Ooh. I know. It's a great drag name. The result is that journalists end up missing big danger signs, signs that mental health experts could catch. Pundits will simply say, “That's just Trump being Trump,” or, “It's tough talk.” One crucial contribution that mental health professionals can make is to But the bigger problem with the APA's gag order is that it surrenders debates about Trump's mental fitness to non-experts. Isn't it remarkable that we're talking about the president's mental state? To political commentators or partisan pundits who actually aren't qualified to talk about this. I'm not a doctor, but I can tell you what I see and hear. I'm not a doctor, but I can see that he is not the sharp mind that he was. I'm not a doctor, but his behavior is erratic. To me, that's classic narcissism. I'm not a doctor but... Leaving mental health issues to pundits, non-professionals, can keep the public in the dark and keep them confused. These discussions can quickly become train wrecks, where mental fitness is used as a weapon to smear political opponents. So many of the traits of a sociopath this man is displaying. I can't explain this crazy behavior, but I can call it crazy. You saw it during the Obama years, when Fox News regularly made wild accusations about Obama's mental state. We all know that Obama is a narcissist, but this is bordering on the pathological. He doesn't seem to have empathy or feelings for Americans. He is certainly unfit to be president. And Lee worries that this kind of coverage trivializes real concerns about Trump's mental fitness, reducing them to just another talking point for pundits to argue about. As this conversation escalates, both sides sort of retreating to their corners. The more that mental fitness sounds like a left-wing talking point, the harder it is to take it seriously. To now say, “Oh, well, look, he seems unhinged,” does seem like you're not willing to accept the political reality that you are living with. To accept that it is simply a political issue or a partisan issue is an attempt to normalize the discourse. No one's a doctor tonight that I've seen. And somehow say, because you don't like what he said tonight in his speech, that he's somehow unfit to be commander in chief, that is the most ridiculous... Whoa, whoa, whoa, everybody stop, stop. The original goal of the Goldwater Rule was to help prevent mental health from being politicized. But if the last few months have shown anything, it's that silencing mental health experts does the opposite. Politicization is almost inevitable without expert input. Mental health expertise, just like medical expertise, is neutral on all those grounds. Trump has made questions about his mental fitness unavoidable. What remains to be seen is whether actual experts will be allowed to answer them.
B2 US Vox trump mental mental health fitness health The awkward debate around Trump's mental fitness 178 16 Samuel posted on 2018/03/25 More Share Save Report Video vocabulary