Professor Laurence Tribe Said this Week:

‘More People Should’ve Listened to these Prescient Psychiatrists in 2017’

This week the very distinguished Professor Laurence Tribe, now emeritus from Harvard Law School—who is also the preeminent mind during the greatest Constitutional crisis in the nation’s history—made the above comment about the first conference at Yale School of Medicine that I organized and chaired regarding our concerns, soon after Donald Trump became president.

I would add that Prof. Tribe is also a good friend and an extraordinary colleague I feel immensely fortunate to have.  While he was the most demanded-upon scholar and spokesperson in our country, with scores, possibly hundreds, calling on him every day from all directions for his advice on how to save American democracy—he did not spare a moment of his time or an ounce of his effort in helping me to ponder, over many days, the puzzling decision on my Yale lawsuit (had I gone to him in the very beginning, it is certain that the courts would not have been able to dismiss it so easily with thinly-disguised reasoning).

Even all the exceptional friends and colleagues who have championed me in the background over the years, including no less than government officials, Yale Law School faculty and former dean, as well as at least a dozen current and former chairs of psychiatry—not to mention fellow faculty with whom I have taught together for years—none could match Prof. Tribe, which speaks to his uncompromising integrity and dedication.

The Independent article that Prof. Tribe linked to his comment had reported on my conference of April 2017, with the title: “Donald Trump has ‘Dangerous Mental Illness,’ Say Psychiatry Experts at Yale Conference.”  The reporter at the time did not distinguish between “mental illness” and “dangerousness” (these are different mental health assessments: not all mentally ill people are dangerous, and not all dangerous people are mentally ill—although a combination could make one more dangerous).

Nevertheless, the reporter correctly stated our claim:

“Donald Trump … is not fit to lead the U.S., a group of psychiatrists has warned during a conference at Yale University.”

My mentor and colleague of twenty-five years in the study of violence, Dr. James Gilligan, said:

“I’ve worked with some of the most dangerous people our society produces, directing mental health programmes in prisons….  I’ve worked with murderers and rapists.  I can recognise dangerousness from a mile away.”

The American Psychiatric Association (APA) tried to silence us even then.  I clarified that I agreed with the original conception of “the Goldwater rule,” which was intended to expand upon our responsibility to society by asserting that we are to improve the community and to better public health through education of the public on psychiatric matters—without diagnosing.  Fine distinctions aside, it should have been obvious that psychiatrists have a duty to society, not just to individual patients, and that there are guidelines to speaking publicly—as we are encouraged to do.

However, in less than two months of Donald Trump’s inauguration, the APA falsely fixated on the “without diagnosing” precept and reinterpreted its traditional meaning to include dangerousness, unfitness, and all other possible comments that could have protected society—essentially creating a new gag order—with obviously political motivations.  There was an exodus of psychiatrists from the APA at this time, including high-ranking officers, such that many were remarking: “The APA is going the way of the AMA [American Medical Association].”

The AMA, having been denounced as more a political than a professional organization, so corrupted and antithetical had it become to medical purposes, now has so few members that it must beg other associations to require membership in the AMA to belong to them, in order to avoid becoming obsolete.

I wonder: does the APA know what it has done?  As a direct result of its interventions, our nation is now in the grip of Trump Contagion—a kind of shared psychosis, which is commonly observed in settings where severe symptoms go untreated, as known about since the nineteenth century (which I have seen a lot of, while working in prisons and other public-sector settings).

We were well on our way to working with key U.S. Congress members to implement a proper response—until the APA stepped in and forbade calling a spade a spade, and Congress could not act without public education and support.  Regardless of any treasured APA “rule”, the APA should have made clear the overriding Rule in psychiatry and medicine that supersedes all other rules—that is, our obligation to the safety and preservation of life.

This is why I opened the conference with the question:

“What if mental symptoms in a position of power imply danger not just to one person or a few, but the whole nation and the world?”

My dear friend of fifteen years at the time, Dr. Judith Herman, made a distinction between entering the political arena on behalf of the power of the state, as the APA has done, and getting involved on behalf of the rest of society that is at risk from the abuse of powers by the state, as we have since done:

“And so if we are involved in resistance of the power of the state, to me that has a different ethical cast, and I can be persuaded by the argument that we have a right, and perhaps even an obligation, to speak out and share our professional knowledge.”

Dr. Gilligan added:

“For us to remain silent here is a sign either of incompetence on our part—or our inability to recognize dangerousness when it is staring us in the face blatantly and egregiously—or it is sheer irresponsibility on our part to remain passive in the face of such an obvious danger.”

Dr. Robert Jay Lifton, another colleague of many decades in the prevention of mass violence, concluded that Donald Trump’s occupation of the presidency gives rise to a dangerous impulse to see his behavior as normal.

“This kind of malignant normality can enter into the governing—or one can say anti-governing—structure of our country.  And there’s no reason that we can’t identify and take our stance against it as dangerous to us and other Americans and to the world.”

Indeed, we have. And ethical psychiatrists continually will.