US psychiatrists 'fear reprisals if they speak out' on Donald Trump's mental health

One therapist tells of flood of 'very crude hate mail' after he went public

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The Independent US

Mental health professionals fear reprisals if they say publicly that Donald Trump may be psychologically unwell, according to a therapist who believes “half of America” is suffering panic attacks because of the President’s actions.

Psychiatrists are afraid they will be sued or reported to professional regulators if they say Mr Trump is suffering a mental illness, Dr John Gartner told The Independent, adding he had received “a lot of very crude hate mail” after speaking out.

Last week he sidestepped the longstanding Goldwater Rule - designed to discourage therapists from attempting to diagnose public figures without having examined them—by calling for a psychological evaluation of the 45th President over what they said were “impulsive” acts, like bombing a Syrian airfield after a suspected chemical weapons attack by the Assad government.

They were criticised by one Republican who said they were ignoring ethical standards for political reasons.

Dr Gartner said: “I do know some colleagues who are worried about being sued. Complaints could be made against their licence. There's a fear of it. Losing your licence is the worst thing that could happen to you. It's enough to make many back off.”

The Baltimore-based psychologist said he believed the American Psychiatric Association (APA), which backs the rule in part because it thinks breaking it could damage patients’ confidence in therapists, would be on the wrong side of history as he compared Mr Trump’s behaviour to that of Adolf Hitler.

He said: “I don’t think it would damage [patients’] confidence in their doctors. When Hitler was rising no German psychiatrists spoke out against him, not one.

“We don’t look upon that now as having been the height of professional ethics. This is the rise of a dangerously mentally ill President. Someone who has a malignant narcissism that makes him a threat.

“I think history will judge the position of the APA very harshly. I’m not saying he’s as bad as Hitler and Stalin, what I’m saying is he’s a member of the same diagnostic group.”

At a panel organised by Yale University lecturer Dr Bandy Lee last week, Dr Gartner employed vivid imagery to illustrate his fears. He said: “I keep being haunted by a fantasy—my adult grandchildren and I are huddled around a garbage can fire, wearing ragged gloves without fingers, slapping our hands together over the flames trying to keep warm.

“Along with other survivors of World War Three, we’re living in a refuge camp in Idaho, one of the last habitable places in America, so remote it was never targeted.”

While Dr Gartner was invited to the event, he was not on the panel itself.

The APA said last year, in a blog post specifically addressing the presidential election, that speaking in this way was “potentially stigmatising” for people with mental health problems.

And JR Romano, the Connecticut Republican party chairman, accused the Yale panellists of “throwing ethical standards out the window because they cannot accept the election results”.

In February another psychiatrist, Dr Allen Frances, spoke out against “psychiatric name-calling” which he said was “a misguided way of countering Mr Trump’s attack on democracy”.

Dr Frances, of Duke University Medical College, headed a taskforce that literally wrote the book on diagnosing mental illness in 1994. He added in a letter to the New York Times: “It is a stigmatising insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr Trump (who is neither).”

Dr Gartner rejected any suggestion his dystopian vision of America as a devastated wasteland post-Trump was political sour grapes.

He said: “I don’t accept it. I don’t think that it holds water. This is a Black Swan situation. It’s not losing an election.

“From election day on, basically half the country has been experiencing a psychological disorder. Half of America is undergoing continuous panic attacks.

“I’m not telling them anything they don’t already know. It’s not controversial to the more than 50 per cent of people who know the person in control is out of control. They know they’re in danger.

“It’s not even like George Bush stealing the election. We were mad. Not like this. People are scared. I would be grateful for a President Pence. He’s just a conservative, he’s not crazy.”

Dr Lee was also quick to play down any question of partisanship. She said she wanted to raise her fears about Mr Trump in part because “of the very special stigma that is attached to mental illness”.

She told The Independent this week: “To say that there are mental health impairments in Mr Trump is not to make a moral judgement on him, and not to indict him in any way.

“It should not be used as a political weapon against him, but rather should be raised as a concern just like any medical issue that may impair an individual’s ability to function in office.

“I actually am afraid of politicisation of this. We wouldn’t make up that someone has cancer, or a disability. Mental health should be treated the same.”

Dr Lee subsequently said her panel had “adhered to the Goldwater Rule in its original conception”, and that a “reaffirmation” of the rule in March had expanded it “beyond any original language”. 

Dr Gartner, a former part time assistant professor of psychiatry at Johns Hopkins University Medical School, even said he thought Mr Trump might start a war to distract from political troubles like the investigation into Russia ties among his team.

“Psychologically he wants to start one. That’s his personality. The risk of something like millions of people dying is extremely high,” he said. “He’s going to shoot his way out.”

Can Mr Trump’s style be chalked up to his political inexperience?

“I think it’s becoming more and more implausible. The simplest explanation for his acting like a Hitler-like malignant narcissist is that he is a Hitler-like malignant narcissist. He seems also to have these crazy conspiracy theories, including even when it doesn’t benefit [him] politically.”

The President’s claim to have had the biggest inauguration crowd ever “made him look insane and dishonest and just crazy,” Dr Gartner said. Mr Trump’s Twitter feed “has got to be the most prodigious record of cyber-bullying ever,” he added.

A Change.org petition started by Dr Gartner that calls on Democratic Senator Chuck Schumer to try to remove Mr Trump from office has some 52,000 signatures. Dr Gartner said it was intended for mental health professionals but the qualifications and identities of many signatories were not clear.

Alongside comments from people who said they were mental health workers and listed their degrees, other people's reasons for signing included: “Trump is raping the nation!” and “he's a nutjob!”.

The Independent contacted the White House for comment when it interviewed Dr Lee about the panel event earlier this week. No response was received.

Update:

This article was amended to reflect the fact Dr Gartner is a psychologist, and was not on the panel at the event, and Dr Lee’s assertion that she and her colleagues were adhering to the "original conception" of the Goldwater Rule.

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