It came to my attention yesterday that a bill has been proposed in the Minnesota Legislature to declare Trump Derangement Syndrome a mental illness. Anyone unfamiliar with the mental illness statutes in Minnesota might ask why there are definitions like that in the law in the first place. The purpose of these definitions is threefold as far as I can tell. First, they define the behavioral evidence in terms of severity necessary to meet the standard of severe mental illness. In common parlance that is typically described as risk to self, risk to others, or inability to care for oneself because of mental illness. No diagnostic criteria or reference to diagnostic manuals is made. The definitions are there as lay standards so that potentially any interested person can act on them. Second, they are necessary criteria for civil commitments, guardianship, and conservatorships in the state. In other words, a psychiatric diagnosis by itself is not sufficient criteria for any of those proceedings. The statutory requirements must also be met. Finally, the criteria also determine eligibility for additional treatment resources like case management and outreach services.
To confirm the validity of this proposal I sent emails to
both of my state representatives Rep. Elliot Engen (R) and Sen. Heather
Gustafson (D). I expressed my concern that the mental health statutes in the
state are for the serious business of civil commitment, guardianship, and conservatorship
proceedings and therefore I needed to know if Trump Derangement Syndrome
was a serious proposal and if it was – what they were going to do about it.
I have not heard back at this point but the press coverage
is increasing so I will talk about it as if it is legitimate. Where does this come from and what does it
really mean? During the previous Trump
election there was a lot of controversy about whether he had a psychiatric
diagnosis – primarily a personality disorder.
There was a lot of discussion about narcissistic and antisocial personality
disorders. There were several high-profile psychiatrists and some academics who
maintained these positions. These
criticisms still surface today. At the
time, I
critiqued those positions based on the APA’s Goldwater Rule. Psychiatric profiling was invented by Jerrold
Post, MD for intelligence gathering and it was not meant to be applied to
politics and the Goldwater Rule states that a direct assessment must be done
and any information released with informed consent. Those controversies
basically faded because the public criticism had no impact and it was obvious
that a lay standard in the 25th Amendment rather than public speculation
is the overriding consideration:
“Section 4:
Whenever the Vice President and a majority of either the
principal officers of the executive departments or of such other body as
Congress may by law provide, transmit to the President pro tempore of the
Senate and the Speaker of the House of Representatives their written
declaration that the President is unable to discharge the powers and duties of
his office, the Vice President shall immediately assume the powers and duties
of the office as Acting President.”
Even though a substantial
number of Trump’s first staff disapproved of his performance or thought he
was incompetent – there was no effort to invoke the 25th Amendment. He was subsequently rated as the worst President to date
by polled historians. We also learned
that if the President or his party control the Supreme Court – it is possible
that an entirely different standard applies than it does to the average
citizen. It is clearly possible that the President can commit crimes and escape
prosecution.
The idea that Trump is an unlikeable person is easily
explored with the following thought experiment.
How many people like liars? Trump is described as lying an unprecedented
amount in the history of American politics – tens of thousands of
lies. At times the lies are
characterized as bullshitting using Frankfurt’s philosophical definition. According to Frankfurt - bullshitters have
more disregard for the truth than liars.
So, pardon me if you think bullshitting is more acceptable. How many people object to a person who routinely
calls other people names and ridicules the disabled? How many object to threats? How many object to racism,
misogyny,
and white
supremacy? How many object to withdrawing foreign aid amounting to less
than 1% of the budget if it results in the deaths of hundreds of thousands of
people (3.3 million according to a New York Times estimate from AIDs,
malaria, TB, lack of vaccinations, and a lack of food). How many people like the administrative, justice,
public health, and research infrastructure of the United States being decimated
on an arbitrary basis by Trump appointed designees? How many people like loyal government
employees working in non-political positions in the US Postal Service, the Veteran’s
administration, and the National Park System terminated either for a completely
fictional cause or without cause? I
think the point is made even though this is only a partial list of what Trump
has done to cause people to legitimately dislike him. I could probably come up with a much longer
list. For completeness sake – let me add
– how many people like a President to attempted to overthrow the US government
and who has continued to lie about the election for the next 4 years?
That brings me to the statute:
Subd. 28.Trump Derangement Syndrome.
"Trump Derangement Syndrome" means
2.24 the acute onset of paranoia in otherwise normal persons
that is in reaction to the policies
2.25 and presidencies of President Donald J. Trump. Symptoms
may include Trump-induced
2.26 general hysteria, which produces an inability to
distinguish between legitimate policy
2.27 differences and signs of psychic pathology in President
Donald J. Trump's behavior. This
2.28 may be expressed by:
2.29
(1) verbal expressions of intense hostility toward President
Donald J. Trump; and
2.30
(2) overt acts of aggression and violence against anyone
supporting President Donald
2.31 J. Trump or anything that symbolizes President Donald J.
Trump.
On the face of it – this definition is poorly written by
people who are obviously not mental health professionals. The wording can be
taken as colloquial rather than technical.
That means the terms “paranoia” and “hysteria” are whatever the
politicians decide to use them for and that could include name-calling. Concern
about the Trump on-again off-again tariffs?
You are just paranoid.
The idea that these meaningless expressions would cause “an
inability to distinguish between legitimate policy differences and signs of
psychic pathology in President Trump’s behavior” is laughable. First, as previously noted nobody is making
any psychiatric diagnoses on Trump. That
time has passed. His party is more than
willing to let him do whatever he wants. Second, it does not take a mental health
professional to decide if someone is unlikeable, or doing things that you do
not like, or using rhetoric that you do not like, or is conducting themselves
in an immoral or unethical way that you do not like. We all do it every day. We are all judged on our behavior every day
and accountable in many ways. The vague
wording in the preamble in this statutory language is intentional and it gives
the proponents plenty of freedom to determine what they think is “intense hostility”
toward Trump. They could at least include
a scale using examples of Trump’s intense hostility to others. As hostile, as
Trump was to Zelensky in the tragic White House meeting or possibility some of
his milder name calling incidents directed at Clinton, Harris, or Obama? The essence of this language is that it sends
the strong message that if you criticize Trump – you are at risk. The “overt acts of aggression and violence…” language
is already illegal without this nonsensical modification.
Like most things in the Trump administration there is no scientific
backing to any of this language. The
rhetoric is slightly more interesting. Anyone paying causal attention to the
news has seen the pattern of outrage followed verbal aggression (mainly name
calling and lying) that is a standard part of MAGA theatrics over the past
several years. If you really have not - just turn on one of their news channels,
podcasts, or radio broadcasts. Better yet – attend a school board meeting and
witness the screams about book banning and other things that are often not even
happening. More recently that has spilled over into MAGA town halls meetings to
the point that the GOP has had to shut them down. Other than the obvious appeals to excessive
and inappropriate emotion in these meetings there are two additional patterns
that cannot be missed.
The first is what I like to call the gangster
approach to pseudo negotiation. This was evident in the meeting between
Zelensky, Trump, and Vance. Before any actual content was discussed both Trump
and Vance were accusing Zelensky of “not respecting them” or saying “thank you’. This is what you will find in any rapper beef
but it obviously has no place in high level diplomacy. What were Trump and Vance trying to do here? To anyone familiar with rhetoric, this is a
standard attack on the person rather than their argument. Zelensky never got
his argument out and then to add insult to injury he was told to leave the
White House.
The second is a variation on that theme. Whenever
Trump is even mildly confronted, he acts like he has been wounded. One of his comments is “You are not very nice;
you are not being very nice to me.” He
will rationalize the rest of his behavior such as refusing to talk or attacking
the journalist or their organization based on that sensitivity. He will often attack the journalist typically
by calling them names or questioning their ability. In some cases, he will suggest that the
interviewer has some nefarious purpose or that they are part of a “fake news” conspiracy
against him. In more recent developments
he is suggesting that the people in the media who he does not like will
be prosecuted.
Both patterns are obvious in the news and in life. We
typically encounter this kind of behavior as adolescents from bullies in schools.
Recall that bully on the playground who likes to make up nick names for
classmates just to humiliate and embarrass them. He persists in using the nick
name even though you and your friends don’t like it. You
all acquiesce because he is bigger and will beat you up if you protest
too much. Occasionally some smaller kid stands up to the bully and punches him
in the noise. At the meeting with the principal – the bully and his father
claim the other kid started the fight.
They are typically outraged and tearful.
That is the real reason for a Trump Derangement Syndrome
statute. It allows even more leverage on
the people who protest the bully. Now
some politician can gaslight them in addition to Trump bullying them and
calling them names.
This is not a mental illness. It is a political tactic. It is an affront to anyone with a real mental
illness, their caregivers and treatment providers. If this language is allowed
to stand in Minnesota it adds to the embarrassments that this administration
has placed on the American people and will result in a gaslighting defense for America’s number one bully.
George Dawson, MD, DFAPA
Graphic:
The graphic in this case is taken directly off the Minnesota
Revisor web site – an official site of the state government. The link I used is available below – but it disappears
and gets updated to a new link frequently:
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