Published April 28, 2020
I’m the last person in the world who believes in conspiracy theories. So if anyone had told me what I read in Joshua Kendell’s article, “Muzzled by Psychiatry in a Time of Crisis: The Man in the White Coat, The New York Times and The Stifling of the Public Debate about Donald Trump’s Fitness to Serve as President,” I would have politely called them paranoid. But here we are… in the midst of a pandemic, already exhausted from three years of chaos, and mental health professionals, like myself, are still trying to convince the country Donald Trump is unfit for office.
I’m not going to recount what is already a brilliant piece of journalism. Please read Mr. Kendell’s article. Rather, I’m going to tell you what it’s been like for a mental health expert to be held on the sidelines watching this spectacle knowing we can help.
I’m a former Army Social Work Officer with 27yrs clinical experience. I also served as the Executive Officer (XO) for the Medical Command for Afghanistan (OEF) in 2009-2010. For the last 3yrs, I’ve been doing the only thing I could think of to get through to the American people, writing articles and posting on social media.
When Donald Trump started to rise in the 2016 presidential primaries, I was as baffled as the press. Why would anyone be impressed with a candidate bragging incessantly about poll numbers and making sweeping promises a child could see through? The more I listened, the more concerned I became. For someone who’s been counseling people for 27yrs, it was obvious: Donald Trump had Narcissistic Personality Disorder.
On November 15, 2018, I published my first blog article – one that had been swimming in my head since before the election: “How Our Cultural Ignorance of Mental Health Helped Elect Donald Trump.” (I had originally submitted it to The Washington Post, but never received a reply.) It infuriated me every time I heard a politician or pundit express hope that Trump would “rise to the occasion” or “surround himself with good people.” I knew this was no more likely to happen than Trump willing himself back to health from Stage 4 prostate cancer.
To understand my certainty, you would need to accumulate years of training and experience. But some mental health experts did the next best thing: they wrote a book called, “The Dangerous Case of Donald Trump.” It contained essays from 27 (later 37) mental health experts and was edited by a Yale University psychiatrist, Dr. Bandy Lee, who happened to be female and of Asian descent. The goal of the book was singular: to warn the American people so they could do something to protect the country. It became a New York Times bestseller. I was sure once the American people were educated on what we saw, they would share our concerns. But then the chatter over the book dissipated.
Imagine sitting in a crowded stadium. Everyone has blinders on but you. You see fire and urge everyone to leave before it’s too late. But they can only smell smoke so they dismiss your warnings. That’s what the last 3+yrs have felt like for mental health experts.
My sense of urgency only increased the more Donald Trump remained in office. “If Congress acted early,” I thought, “they could set certain constraints to protect the public.” Yes, there were political forces at will, but the public was only hearing one side of the story.
Perhaps naively, I kept trying to do my part. I wrote two more articles in June 2019: “The Media’s Missed Opportunity,” addressing what seemed like naivete on the part of the press in covering Donald Trump; and “We’re No Different. Neither Are They,” comparing my Jewish heritage to the treatment of immigrants at the southern border. As the granddaughter of a Polish immigrant who lost his entire family in the Holocaust, I was in horrified disbelief over this policy.
Meanwhile, mainstream media was fixated on the Mueller investigation. I had no illusions the press would pay attention to my blog articles, even on an empty news day, but I was hoping I might spark something on Twitter.
Dr. Lee was also writing articles and granting interviews, but they were equally ineffective in generating media buzz. My frustration turned more and more toward news outlets. The raging sea that was the Trump administration rolled on, damaging democratic institutions, diplomatic relationships and long-term policy for reasons that can only be explained by Malignant Narcissism. Everything Mental Health Experts had predicted was coming true and we were rendered helpless to stop it.
In July 2019, reports surfaced that Donald Trump had approved a military strike on Iran, then pulled back the last minute. I started another article. I wrote at the time,”This breaking news, if true, should terrify everyone,” But the impeachment process was just getting underway and the incident was quickly forgotten.
If by now the America people felt they were being jostled from crisis to crisis, it was no accident – not because Donald Trump was deliberately creating them, but because he was impulsive, reactionary, disorganized and selfish. There was no “method to Trump’s madness,” only madness. There’s a term in psychotherapy called “use of self…” We all knew what was going on in Trump’s head because we’d been living it for the last 3yrs! Did any of this feel strategic to you???
The Fall of 2019 brought House impeachment hearings and, with it, a furious debate over how long the House should hold investigations. James Robenalt wrote an article for The Washington Post recounting the “drip, drip, drip” of revelations about Watergate. “In fact,” Robenalt recounted, “Bob Woodward and Carl Bernstein wrote relentlessly about the scandal [but] Americans were largely unmoved.” Meanwhile, I could see the political writing on the wall and churned out another article urging the House: “Hold All the President’s Men Accountable.” If Donald Trump was not impeached or at least sanctioned, I knew he would be even more dangerous than before.
By this time, one of the most troubling events of Trump’s tenure had occurred. Without consulting his Secretary of State, Director of National Security, Director of Defense Intelligence, military leaders or allies, Trump unilaterally withdrew US Special Forces from northern Syria. The weight of this news was crushing. As I thought about our country’s betrayal to thousands of Kurdish families, I felt I had personally let them down.
Still nobody in the media stratosphere was addressing the elephant in the room: Trump’s psychopathology. As impeachment shifted from the House to the Senate, I wrote my next article, “Impeachment: Right Idea, Wrong Remedy.” By now, I had come to the conclusion that the news media regarded Trump’s removal from office under the 25th amendment as a political non-starter and saw no point in even entertaining it. I, on the other hand, had a different take: while I knew Trump’s cabinet would never remove him from office, it was also unlikely the Senate would impeach him. There was still value in discussing Trump’s mental health. Congress could install limits on Trump’s powers, as they ended up doing after he ordered the killing of Iran’s General Qasem Soleimani. Also, didn’t voters deserve to hear from mental health experts before going to the polls in November?
Over the course of Trump’s presidency, news outlets solicited experts in law, national security, military service and, most recently of course, medicine. I was used to the stigma, even dismissal, of the mental health profession, but this was gut-punching. By now, Donald Trump’s mental instability was not only out in plain site, the country was reaping untold damage from it. Malignant Narcissism was the one common denominator. “Why,” I deliberated, “was Congress and the press still refusing to talk about it?” Was mental health held in such contempt that we didn’t deserve a seat at the table?
Which brings me to yesterday: when it all became clear. The American Psychiatric Association (APA), led by Jeffrey Lieberman, MD, had deliberately and strategically shut down Dr. Bandy Lee and the co-authors of “The Dangerous Case of Donald Trump.” And they collaborated with The New York Times to do it. As Joshua Kendell details in his article,
The New York Times lined up with the APA against Lee, publishing both an editorial in support of the new Goldwater rule and an op-ed by Lieberman in which he accused Lee of engaging in “clinical name-calling.”https://www.madinamerica.com/2020/04/muzzled-psychiatry-time-crisis/
Due to social ignorance of mental health, the public would not know enough to question the APA’s authority, but The Times should have.
First of all, the American Psychiatric Association (APA) is a trade association. While it can make recommendations to it’s members, it is there to serve them not dictate the scope of their practice. Like any professional association, a psychiatrist can choose to be a member of the APA to take advantage of benefits like trainings, guidance on best practices and to be a collective voice for the profession. As a social worker, I have the option of becoming a member of the National Association of Social Workers, but it is unfathomable that the NASW would interfere with my professional conduct. If I was engaging in unethical behavior, it is the state licensing board’s authority to issue sanctions against me.
Furthermore, the APA has no business dictating the practice of other mental health providers. We are a diverse community with varying skill-sets. Each discipline has unique roots, but there is also crossover in what we do. Unfortunately, we live in a society that equates credentials with expertise. The idea that a psychiatrist’s opinion should be given more credence than mine simply because he holds a medical degree is not only ignorant, it’s dangerous. It also smacks of old-school paternalism that should have been tossed out with the 20th century. Many psychiatrists today focus entirely on medication management. They have nowhere near my experience counseling patients.
How dare The New York Times make a unilateral decision to apply a trade association principal to all mental health professionals! The APA does not speak for Social Workers, Professional Counselors, Marriage and Family Therapists, Psychologists, Psychiatric Nurse Practitioners, or even all Psychiatrists. Nor does the APA have authority over anyone other than it’s members. If the American Orthopedic Association came to The Times demanding they write an op-ed that all mental health professionals should learn the parts of the skeleton before practicing independently, would they support that, too?
The New York Time’s capitulation to the American Psychiatric Association can be described only one way: as journalistic malpractice. Tragically, it’s the American people, not it, paying the ultimate price.