Many people are questioning President Trump’s mental health. This month, Representative Ted Lieu, a California Democrat, went so far as to say he was considering proposing legislation that would require examinations by a White House psychiatrist.
Richard A. Friedman, professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College, believes this would be a mistake.
From an op-ed in The New York Times, February 17: “I don’t doubt that…experts believe they are protecting the country from a president whose behavior they – like many of us – see as dangerous. A recent letter to the editor in this newspaper, signed by 35 psychiatrists, psychologists and social workers, put it this way: ‘We fear that too much is at stake to be silent.’ It continued, ‘We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president.’
“But the attempt to diagnose a condition in President Trump and declare him mentally unfit to serve is misguided for several reasons.”
Professor Friedman elaborates one of these reasons: “…While it would be unethical for a psychiatrist to say that President Trump has narcissistic personality disorder [without having examined him], he or she could discuss common narcissistic character traits, like grandiosity and intolerance of criticism, and how they might explain Mr. Trump’s behavior. In other words, psychiatrists can talk about the psychology and symptoms of narcissism in general, and the public is free to decide whether the information could apply to the individual. This may seem like splitting hairs, but it isn’t. Diagnosis requires a thorough examination of a patient, a detailed history and all relevant clinical data – none of which can be gathered from afar. Narcissism, for instance, isn’t the only explanation for impulsive, inattentive and grandiose behavior. Someone could be suffering instead from another clinical problem like attention deficit hyperactivity disorder; the abuse of drugs, alcohol or stimulants; or a variant of bipolar disorder, to name just a few.
“This is all to say that when mental health professionals label public figures with mental illnesses, it is not just unethical – it’s intellectually suspect. We don’t have the requisite clinical data to know what we are talking about.”