Tragedies of anti-Trumpism: Extra-clinical and public mental health diagnoses

Statement of the problem

I have been critical of others' decisions to issue extra-clinical and public diagnoses of Mr. Trump's mental health. (See asterisked* footnote below about my word choice here.) While it seems almost everyone (who opposes Trump) does it, I have reserved much of my criticism for mental health professionals who do so. (See, for example, this post, cross-posted with Hit Coffee. Be sure to read this comment on Hit Coffee from Dr. X, who disagrees with what was then my argument.)

I have since come around, albeit grudgingly, to admitting that mental health professionals are not violating professional ethics when they make well-considered statements about Mr. Trump's, or any other public figure's, mental health. I still believe that these professionals, even those for whom I have a lot of respect, too often fail to parse what they know from observing Mr. Trump and what they can't know without further knowledge to which they don't have access. They also seem to flounder when it comes to distinguishing between their views as citizens and their views as professionals. Or, if they believe the roles of "citizen" and "professional" are so entwined as to be inseparable, they tend not to acknowledge the problems inherent in mixing professional opinions and political opinions. Finally, I suspect the claims that mental health professionals "can't" offer such opinions to be greatly exaggerated.

With that out of the way, though, I'll stipulate for the sake of this blog post that such public discussion and diagnosis of Mr. Trump's mental health are necessary. I'll also stipulate that mental health professionals participate in these discussions as responsibly as we can expect in a free society when an important matter of public controversy is at hand.

Tragedies of extra-clinical and public diagnoses

With those stipulations, I find "tragedies" from the extra-clinical, public diagnoses:

Extra-clinical, public diagnoses stigmatize mental health problems

No matter how much mental health professionals say that identifying dangerous tendencies is not the same as saying all, or even most people with mental health problems, members of the public will likely infer that from those professionals' public pronouncements. That's on the members of the public for not heeding what is said. But it's a predictable result nonetheless.

Extra-clinical, public diagnoses creates a backlash

Trump supporters, or even people who purport to oppose Trump but who question the tenor of some of the opposition, will respond negatively to these diagnoses. These diagnoses will help solidify some persons' support or temper some persons' opposition.

Extra-clinical, public diagnoses create a dangerous precedent

There's always going to be some mental health professionals, or at least people with the appropriate credentials, who will offer an assessment of a politician's mental health. And there will always be at least superficial evidence to support that assessment. That doesn't mean every situation is equivalent. Sometimes people are peculiarly unfit for their position and that unfitness needs to be assessed and acted on. But offering public, extra-clinical diagnoses in the one instance makes it marginally easier for others to do so later.

Send off

I've said a lot about professionalism. As a layperson in this area, I realize I'm speaking out of turn. A professional, speaking as a professional, needs to conform to the rules of that profession or at least note when they depart from those rules. As someone trained in U.S. history, for example, I must state in good and honest conscience that the Civil War was primarily a war over slavery and that the South seceded from the North primarily to protect slavery, even though my saying so might anger a good number of people who in other circumstances and on other issues I might wish to count as friends. (Why I'd want to count them as friends is perhaps a different question. But just suffice it to say that we all have friends and family who we love but cannot agree with everything they believe in.) That's burden of professionalism, and I recognize that members of other professions share like burdens.

I also wish to remind readers that I'm speaking of what I think are almost inevitable outcomes, of outcomes that are part of the expected costs people pay for doing what they believe is the right thing. Those costs, or "tragedies," as I call them, are there whether or not it's necessary to incur them. I'm less convinced than some mental health professionals that declaiming against Mr. Trump's mental fitness is as necessary as they seem to believe. But even if it is necessary--and even though it's unfair to all those mental health professionals who make public, extra-clinical diagnoses out of a sense of duty and with the fullness of caution their ethics require--those costs will nonetheless be exacted.

See introduction and table of contents for this series

*Footnote about word choice

By "extra-clinical diagnoses," I mean diagnoses offered without the benefit of the typical face-to-face evaluations mental health professionals usually engage in before making diagnoses. I also mean diagnoses offered without the follow up information gathering that may lead a mental health professional to revise (or confirm) their diagnoses. Finally, I mean "diagnoses" that venture to state what can't be known. It's one thing, for example, to say that Mr. Trump "probably won't change" or will "find it very difficult to change" or even, "on the basis of everything I've seen so far, and acknowledging that there's a lot I can't know from my vantage point, Mr. Trump can't change." It's another thing to say simply that "he can't change." I'm just a layperson, but I find it hard to believe that responsible mental health professionals say a person "can't" change without ever having had a chance to evaluate and work with that person for a time. I might be overly exacting in my demands on others' word choices. But professionals who purport to speak as professionals should be exacting in their word choices.

By "public," I mean information and evaluations offered about the mental health, or personality constellation, of a person that a mental health professional would not be permitted to offer without that person's consent if that person were a client. I suppose there's a gray area here, where a mental health professional may sometimes be permitted or even required to alert the public about a client who, for example, may hurt themselves or others.

By "mental health," I mean not only the distinction between "healthy" and "unhealthy" mental states, such as is indicated by finding a given person suffers from OCD, bipolar disorder, or psychosis. I also mean comments about "personality constellation" or other attributes that don't fit as easily onto a spectrum of what is mental health and what is mental illness.

UPDATE 3/8/2019: I've fixed a few broken links.

Tragedies of anti-Trumpism: The Russian investigation

The investigation

Most are aware of the charges that Russia may have somehow tried to influence the 2016 presidential election and that Russian interests have a disproportionate influence in the operations of the Trump administration. One claim is that a Russian agency, the Internet Research Association, somehow manipulated social media to target certain groups of people in the United States to influence their vote with "fake news." Another claim is that high-level operatives, like former National Security Advisory Michael Flynn, was somehow in the pay of Russian operatives from other countries. A third claim is that Trump is deeper in cahoots with the Russians, receiving difficult to trace contributions from Russia in exchange for Trump advancing Russian interests. As I understand it, Russia isn't the only foreign power alleged to exert undue influence, but the news I've seen focuses on "Russia" and Putin.

In light of these charges, part of the investigation into Trump has to do with his, his administration's, and his campaign's dealings with Russian and other foreign operatives. The questions behind this investigation seems to be what did they know, when did they know it, and how might they be compromising national security because of it?

This investigation needs to be done, and if it uncovers illegal actions, those actions must be prosecuted. Even if what it uncovers is not illegal, it may uncover questionable dealings that should call into question the competence and good faith of the Trump administration.

Three tragic consequences

But however necessary the investigation is,  into Trump's dealings with Russia may do, I see three potentially unfortunate consequences. unfortunate, potential consequences. First, the investigation feeds into a narrative of knee-jerk anti-Russianism and hyper-American nationalism and all the unsavory historical associations that come with that narrative. Second, the investigation glamorizes Putin.

Un-reflective attacks on free speech

One concern the Russian investigation has brought out is that "fake news" bombards social media and manipulates people to vote a certain way or not to vote at all. One possible reaction to "fake news" is advocacy for more gate keeping in the distribution of information. I fear that gate keeping can be unduly strict and may limit what can be said.

It all depends on what kind of gate keeping we're talking about. The fewer and more centralized the gate keepers--and the more formal and rigid the gate keeping process--the more danger. The more diffuse the gate keepers and the more access we have to alternative, non-gate-kept information, the better. To be clear, I haven't yet seen any serious proposal that might raise concerns. The only proposal I've actually seen (and at secondhand, so I don't have a link) is combat trollery on social media so as to provide more transparency about who is providing what information and in whose interests that information is being provided.

Another red scare?

The investigation revives our periodic obsessions with Russia and with anyone who may plausibly be smeared as "pro-Russian." That isn't too different from our other periodic obsessions, such as the war on terror or the anti-Japanese sentiment in the 1980s. But I'd just like to point that we've seen this movie before. The sides seem to have changed a bit. Those who say "but there really is a danger" tend now to be more on the left. Those who say "this is hysteria" or "this is a nothingburger" are probably more on the right. (Here I'm using commonsense, and therefore overbroad and vague, definitions of "the left" and "the right.")

That the sides have switched doesn't mean there's no danger. I should be wary of reasoning by analogy or assuming that because two situations have one thing in common, they have other things in common. But the similarity to other campaigns about "foreign intervention" should give at least a moment's pause. Will the allegations of "pro-Russianism" go overboard and start to ruin lives? Will anyone who raises the possibility that Russia isn't as great of a danger eventually be branded as "traitors"?

Probably not. I said the similarity to concerns the US has seen about foreign intervention should give us "a moment's pause." But I wouldn't say it should give us two moments' pause.

The greater glory of Putin

The investigation serves Putin's interests. Or rather, Putin will find it easy to spin the investigation in a way that buffs up his domestic standing. Maybe Putin is a danger to the US and maybe what Trump and his friends have been doing really does compromise national security or at least signals corruption. But every revelation of how Russia engineered a "fake news" campaign or somehow influenced the 2016 election likely plays into Putin's hands. Maybe Russian experts can tell me where I'm wrong, but I strongly suspect Putin gets a lot of leverage, in the form of bragging rights, by portraying himself as the guy who messed with the American elections.

That perhaps is the most "inevitable" of the tragedies from the Russian investigation. It's obviously (to me) something that needs investigating and it's impossible to investigate in a way that won't redound to Putin's interests.

Conclusion

My warnings about the potential attack on free speech and the next "red scare" are slippery slope arguments. My warning about how Putin may shape the investigation to his own interests is, if not trivial, perhaps to be expected and not particularly in anyone's control. But I believe there's no harm in keeping these concerns in mind.

See introduction and table of contents for this series

Tragedies of anti-Trumpism: Introduction

I write this post to introduce a new series that I call "the tragedies of anti-Trumpism."By Trumpism, I mean the facile appeal to bigotry and to authoritarianism that Trump--but not only Trump--represents. By "anti-Trumpism," I mean opposition to Trumpism.

Yet any serious effort to combat Trump and Trumpism entails, almost necessarily, certain costs to anti-Trumpists' own integrity and to those in whose name they pursue their activism. These costs are "tragic," not because they are too high to justify opposing Trumpism, but because opposing Trumpism almost necessarily exacts these costs.

I mostly join those who say we must remove Trump from office by any legal means necessary and that we must combat Trumpism. I say I "mostly join" and not "completely join" because I'm not convinced that just because a means is legal it is therefore the right thing to do. But that's a conversation for another day. And I certainly am not endorsing illegal means.

I'm aware I'm doing what is sometimes called "anti-anti-Trumpism." That term refers to those who oppose (or at least don't support) Trump but who are bothered by the way others oppose him. I'm aware of the allegation that this "anti-anti-Trumpism" is a bad thing, akin to support for Trump and what he stands for by way of nitpicking and finding fault with any and all criticisms but not actually doing or saying anything meaningful to call Trump and Trumpism to account.

In light of that allegation, I must concede several points:

• My series of blog posts will be a species of anti-anti-Trumpism.
• On some level I am indeed offering something like support for Trumpism inasmuch as Trump's supporters take refuge in criticizing his opponents.
• Other than penning a few criticisms of Trump (an exercise that, like talk, is cheap) and other than voting for Hillary Clinton, I have done nothing substantive to oppose Trump.
• I have less to fear from Trumpism than others who are more marginalized than I am and therefore it's easy for me to criticize those who have more to fear and more to lose.
• I feel a certain amount of personal defensiveness when I hear people criticize Trump, Trumpism, or Trump supporters. That defensiveness has more to do with my own pride and perhaps baser inclinations.

At the same time, I find it inadvisable to remain silent. Whatever incidental support for Trump or Trumpism my series offers,* I believe that even anti-Trumpists can benefit from reflecting on the costs to themselves and to others that result from their activism. At the very least, I believe it's preferable for activists of any stripe to go into their activism with eyes wider open.

Table of contents for the series

• Link to series tag
• Introduction
• The Russian investigation  
• Extra-clinical and public diagnoses

*Let's face it, my blog doesn't exactly have a wide readership. I've thought of posting this series, or parts of it, over at Ordinary Times, but for now I am not doing so. In part that's because I'm not prepared to deal with the (in my opinion, mostly legitimate) pushback I'd receive.