The End of American Democracy

… And Human Civilization, if Not the Species

Nobody is getting it.  But all the analyses and the postmortems in the world will be fruitless without addressing the central if not only issue that overwhelms everything else: mental pathology.

Lunatics are now running the asylum, and we are about to find out how much peace, prosperity, security, and sanity are attributable to democracy (fascism occurs to the degree of the ruler’s mental incapacity to tolerate democracy).

It is tragic that we must learn through actual experience of uprooting, as we enter the realm of “pathocracy”, as Polish psychiatrist Andrzej Łobaczewski put it.  It was our choice not to access the knowledge we had, just as we chose to apply little infectious disease knowledge to Covid-19, creating a modern plague for ourselves.

It is all heart-wrenching, since it did not have to be—just as we could have kept Covid-19 at the epidemic stage.  The germ does not create a pandemic; our response and the environment we create for it does.

This is why I always emphasized that I was not really speaking about Donald Trump.  “Donald Trumps” are a dime a dozen in my practice, but my job is to keep them contained, to manage them, and to protect society from them.  If any got out, the natural course of action is to alert the public, and to educate and intervene so as to prevent its duplication and spread.  Medicine is supposed to apply neutrally, regardless of the position an afflicted individual holds.  But when an institution such as the American Psychiatric Association (APA) compromises itself, placing power (and its profit) above principle, the effects extend and reverberate exponentially.

Signs of the APA’s compromise were the reason I decided to come out publicly in early 2017.  Once the APA capitulated, the capitulation of all the rest was a matter of course—for how would one deal with a rapidly-spreading mental health pandemic without mental health expertise?  That is how the media fell in line next (after the APA met with the New York Times), then the U.S. Congress, then the Department of Justice, and finally the U.S. Supreme Court—which directed all the other courts, including the only court in the Manhattan District that was behaving normally.

My postmortem is therefore the January 2018 New York Times article by the Editorial Board (which serves as past APA President Jeffrey Lieberman’s crude and unprofessional mouthpiece, like all APA press releases of that time; my acrid comments are in bold italics):

Is Donald Trump mentally fit to be president of the United States?  It’s … beside the point.  Is it?

… we don’t need a medical degree or a psychiatric diagnosis to tell us what is wrong with Mr. Trump.  It’s obvious to anyone who listens to him speak, reads his tweets and sees the effects of his behavior.  Was it?

Presidents should not, for instance, taunt the leaders of hostile nations with demeaning nicknames and boasts about the size of their “nuclear button.”  They should not tweet out videos depicting them violently assaulting their political opponents….  Wouldn’t the public like to know if he would redefine what is acceptable, if we did not intervene in time?

Unfortunately, a number of psychiatrists, politicians and others who should know better have increasingly taken up the Trump-is-crazy line.  In “The Dangerous Case of Donald Trump,”… more than two dozen contributors, most mental-health professionals, concluded that Mr. Trump presents a grave and immediate danger to the safety of America and the world.  No argument there….  Really?

Dr. Bandy Lee … said the authors are “assessing dangerousness, not making a diagnosis.”  Anyone with access to newspapers or Mr. Trump’s Twitter feed can do the same….  “You don’t have to be an expert” is the APA’s disinformation trope used to deprive the public of knowledge—when the public was hungry for knowledge, which is why our book on expertise was a runaway bestseller.

The language of mental health and illness is widely used yet poorly understood, and it comes loaded with unwarranted assumptions and harmful stereotypes.  There’s a good reason the profession established an ethical guideline in 1973, known as the Goldwater Rule, that prohibits psychiatrists from offering professional judgment on public figures they have not personally examined.  Ironically, studies show that “harmful stereotypes” form from lack of discussion, not too much of it—and this is how the Goldwater Rule, in the public’s impression, turned into a “prohibition” rather than the affirmative obligation that it was: to educate the public about public figures, only without diagnosing!

… So what’s the right way to deal with Mr. Trump’s evident unfitness?  Not the 25th Amendment…. [Not] Impeachment….  The best solution is the simplest: Vote….  In November, you can help elect members of Congress who will fight Mr. Trump’s most dangerous behaviors.  If that fails, there’s always 2020.  Was there really a 2020?  A 2024?  The capacity to choose rationally will only grow less with the spread of Trump Contagion.

The 1940’s New York Times incurred criticism for burying Adolf Hitler’s atrocities in its back pages.  But today’s Times wholly applied the APA’s ethical acrobatics and scientific disinformation to rebuke, defame, and bury those who conscientiously tried to speak up about Donald Trump—effectively for all the media within weeks.  This is the reason I have said it is more dangerous now than in Nazi Germany, not because of one person but because of our collective response.

Announcement:

Dr. Bandy X. Lee will hold a live session on:

“How to Navigate an Increasingly Dangerous World”

Friday, November 15, 2024, at 12 noon EDT/9 a.m. PDT on Zoom.  A paid subscription is required to receive a link the morning before.  Thank you!

Dr. Lee is a forensic and social psychiatrist, president of the World Mental Health Coalition, and cofounder of the Violence Prevention Institute. She became known to the public through her 2017 Yale conference and book with 26 other psychiatrists and mental health experts that emphasized the importance of fit leadership.  In 2019, she organized a major National Press Club Conference on the theme of, “The Dangerous State of the World and the Need for Fit Leadership.” In 2024, she followed up with another major National Press Club Conference, “The More Dangerous State of the World and the Need for Fit Leadership.” She also published another book with 39 other psychiatrists and mental health experts, in addition to a volume explaining how unfitness in a leader spreads, and spearheaded two critical statements on fit leadership. Dr. Lee taught at Yale School of Medicine and Yale Law School for 17 years before joining the Harvard Program in Psychiatry and the Law. She was chief resident at Massachusetts General Hospital, research fellow at the National Institute of Mental Health, and consultant for the World Health Organization. She authored the internationally-acclaimed, Violence: An Interdisciplinary Approach to Causes, Consequences, and Cures; over 100 peer-reviewed articles and chapters; and 17 scholarly books and journal special issues.