Saturday, February 18, 2017

Don't insult me by comparing me to Donald Trump

Many people find Donald Trump's actions... worrisome. I am one of them. Many mental health clinicians have decided to pathologize him as a psychopath or narcissist. I am not one of them.

Trump is a repugnant human being and unfit to be president. He may have Narcissistic Personality Disorder. But with or without NPD, he is unfit to be president. It's unnecessary to diagnose him. And it's insulting to those of us with a mental disorder who aren't total assholes to have clinicians harping on how "pathological" Trump is.

I got into a bit of a flamewar today on the listserv of one of my professional organizations. Someone had posted a link to a distinguished psychiatrist's op-ed in The New York Times. This psychiatrist thinks it's irresponsible of professionals to diagnose someone they've never met in person.

I agreed, and decided to post as well:

I think the rush to diagnose and condemn Donald Trump is the worst kind of stigma reinforcement. The most important social action we can take as mental health clinicians is to advocate that people with mental illness who engage in treatment and participate in their recovery are able to have meaningful lives and contribute to society. Writing a public letter or convening a grand rounds in the absence of any contact with the client is not only irresponsible, it reinforces the concept that mental illness renders people inferior to "normals."

Clearly Trump's behavior and judgment are appalling. He embodies the worst kind of white (orange) male privilege, selfishness, prejudice, narrow-mindedness, stubbornness, cronyism, etc. But to say that this appalling behavior must mean he is mentally ill and therefore unfit for office implies that many or all people with a mental illness are similarly "unfit for office," irrational, lacking judgment, etc. People with a psychiatric diagnosis who are NOT despotic, bigoted jerks are offended to be grouped with Trump.

All that is needed is a focus on his behavior--what he says and does--and holding him accountable, like the representatives in Congress who are pressing for further investigation into the Flynn treason. It's obvious that Trump's behavior renders him unfit for office and his deportment is not statesmanlike. There are many ways to resist this presidency (and advocate for those adversely affected by policy changes) without disparaging millions of Americans en masse by comparison with a bloated buffoon.

(I was so tempted to come out to the listserv like I did in the Bronx. Include myself among the mentally ill who disavow any likeness to Trump. But I'm job-hunting (my great clinical job turned to utter crap when they transferred me to an operations role), and as the next post will show, plenty of mental health clinicians are violently prejudiced against the mentally ill.)

A self-important psychoanalyst (SPA) disagreed with me.

Many in our profession, certainly not all , consider Donald Trump to be a dangerous psychopath aspiring to create a dictatorship, and feel a duty to warn in whatever way we can . Had we lived in the time of Stalin or Hitler., would we all be telling each other to stop talking? Those of us who feel the situation is much too close to these historical situations are doing what we believe is right and necessary . Those who disagree are free to do so as long as we continue to live in a  free  country. The concerted effort of the Trump administration to discredit the Free Press cannot go ignored by anyone interested in preserving democracy in this country . I am tired of being lectured by people telling me and others like myself to keep our mouths shut, something Steven  already told the Free Press to do. Sorry, it's not going to happen here.

He was so incensed, he wrote "Steven" without appending "Bannon." SPA authored a book about "traumatic narcissism," which apparently is related somehow to "subjugation." Clearly he believes he has a vested interest in all things narcissist. And I didn't tell him to shut up, just not to violate the Goldwater Rule. Another poster agreed with me:

I do agree with Ayelet, it is completely unethical to diagnose someone whom you have not met and done a complete intake exam, psychosocial, medical and  psychiatric history, etc. Where I also object is to the reinforcement and promotion for "hate," of any kind. I will not support it. 

I didn't see that before I posted this:

Then resist politically using democratic means. There are a million ways people are resisting and protesting this presidency. Don't try to diagnose somebody you have never met.

To be fair, I should include that a few people agreed with SPA, or at least said they did before agreeing with me (very diplomatic; I hear the State Department has dozens if not hundreds of available positions):

Agreer #1. Thank you for your posting.  I fully agree that we cannot, and must not, keep our mouths shut. 

I don’t believe an actual ‘diagnosis’ is the best idea.  For one thing, many of us may arrive at different diagnostic conclusions. More important, I think, is to for us to describe Trump’s multiple symptoms and talk about the risk of discounting information of this sort.  I also think we should think of having clusters of professionals as in the 80’s—eg., Physicians for Social Responsibility, Performers for…, Lawyers for….Such constituencies were very effective during the disarmament and anti-nuclear days; they worked together and separately and always collaborated when collective efforts mattered.

Agreer #2. Just want to say I appreciate so much your thoughts on this subject & how you have expressed them. (It doesn't surprise me, of course, from the author of Traumatic Narcissism.)
I believe we are confronting a situation that challenges our normally civilized attitudes & behaviors-- the habits of fairness, willingness to compromise, acceptance of those who disagree, yielding to majority   decisions, restraint re: 'off-site' or 'no-sight' psych evaluations-- all  valuable principles that yet can weaken our resolve to stand firm against truly unacceptable behaviors & positions and a genuinely dangerous threat to our democracy. Yes, surely there is a duty to warn-- even about the obvious.

I agree with Ayelet that it is not a stigmatizing diagnosis, but actual behavior, that shows him to be unfit for office. But the diagnostic label can offer a coherent way of conceptualizing the behavior, a lens for understanding it, and--together with history-- an alert to where it may lead.

However, do we really want to add confusion by conflating narcissism or even psychopathy with 'mental illness'?-- which to most people has a different set of connotations-- and in fact a different meaning. As well as different expectations of treatment outcome.

How did SPA respond? Well.... kinda like a wounded narcissist:

Then let's been all the books by Erich Fromm and Erick Erickson!

He didn't acknowledge the others who posted in accordance with some of what he said. Just fired off a shot. I assume he meant "burn" instead of "been," and remembers the proper spelling of Erik Erikson when he's not typing in a narcissistic rage. For the record, I think Fromm and Erikson have their place, but I really doubt he's earned a spot beside them.

I was tempted to point out his resemblance to Trump--they are both narcissists! and one of them wrote the book on narcissists!--since I was curious about how he'd respond to that kind of a poke. But again--I'm looknig for a new job, and I don't want to appear confrontational.

It is astonishing to me that in the 21st century they're still publishing books that psychoanalyze narcissists. I really need to get my act together and publish my book. Just as soon as I've made a few more gains in therapy. Which is going very slowly. I know that's the right way to do it, but I'm not a very patient person. I just want to remember what I've repressed.

Like the other serious boyfriend my mother had, when I was about 8 to 11 years old. Who lived in a farmhouse in a nearby town. And took me there--by myself, without my mother or sister--for at least one weekend.

I remember going on the weekend. I remember seeing a mouse in a big room filled with grain that was part of the barn. And that's all I remember. I loved him for a while. And then I hated him.

But I don't know why I started hating him. I eally have no idea, and that is bothering the shit out of me. Did he abuse me as well? Is that why he wanted to marry my mother? She accepted his proposal at first,. I remember him moving toward me, saying, "I want to hug my new daughter!"

And I shouted, "I am not your daughter!"

I was such an unhappy child. Ever since my father died. For decades, starting in college, I tried not to think about all those bad memories. And now when I need to know what happened to me, I can't access them. It's infuriating. I don't know why my mother didn't marry him. If it had anything to do with me.

But I doubt that. It seems pretty clear that my mother didn't recognize child sexual abuse when it was happening in her own house. Like so many other victims who go on to have children of their own. That's how it's perpetuated.

Are the secrets and keys to my current unhappiness locked in my own recalcitrant memory?
Copyright (c) "Ayelet Survivor"

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