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Tuesday, February 5, 2019

Trump may see war as the only option he has left

Trump’s presidency is a mental crisis engulfing the nation: Yale psychiatrist
Related imageOn January 31, President Donald Trump declared that he was not concerned about Special Counsel Robert Mueller’s probe.

He claimed that departing Deputy Attorney General Rod J. Rosenstein had told him he was not a person of interest in the investigation.

“He told the attorneys that I’m not a subject, I’m not a target,” Mr. Trump told the New York Times.

Nevertheless, the probe seems to be circling closer to the president and his family. The arrest of long-time Trump ally Roger Stone—and wording in his indictment that suggested he’d been directed to perform criminal acts by a more senior campaign official—spurred discussion that Donald Trump Jr. or even Trump himself would be implicated in Stone’s alleged crimes.

Trump also told the Times that he would build a wall along the Southwest border with Mexico regardless of Congress.

Raw Story spoke with Yale psychiatrist Bandy X. Lee about how the latest developments are likely to impact the president. Lee’s views are her own, not a reflection of Yale’s position.


Raw Story:  With the indictment of Roger Stone, Special Counsel Robert Mueller’s investigation seems to be edging closer to the Trump family, what are your concerns about how Donald Trump might react? Are you concerned that due to all this pressure, Trump might snap and start a war?

Image result for trump is dangerousBandy X. Lee: His anxieties are palpable, as he resorts to more and more extreme measures and unreal justifications for building a wall. 

We had the extended shutdown that put us at real security risk, according to the FBI, and declaring a national emergency is a very real possibility.

He needs to maintain his shrinking base as well as to give himself a sense of victory, and he will go to all lengths to achieve it. What concerns me, however, is our own lack of readiness for when the real crisis comes. As a nation, we continue merely to react, while dangers escalate, and underestimate the profound effects that mental instability can have.

With all the negative news for Mr. Trump, “rational” people may feel relief, as he is finally held to account, but while being driven to a corner, the president’s only desperate remaining diversion may be war. Forces around the globe—the Israelis and the Saudis, for example—want that for their own reasons, and with a foreign policy team that now reflects his psychology, times could turn incredibly dangerous.

Raw Story: Is the extreme focus on the president productive?

Bandy X. Lee: For all the fixation on the president, understanding around the real indication for active intervention and prevention, right now, is lacking. 

Human beings are malleable and can adapt to almost anything—but this means that we can habituate even to a “malignant normality” where all kinds of atrocities happen. As a mental health professional, 

I spend a lot of time convincing patients of the need for treatment, because the greater the need, the less likely they are even to recognize the relevance of mental health.

So it is with society, and we are now living a situation where a mental health crisis is engulfing the nation, and we scarcely recognize it as a mental health issue. 

Do we really know, for example, what it is like to lack a basic human characteristic, such as empathy, and be willing to destroy lives for the most casual reasons? 

Do we really appreciate what it is like to be so impulsive that one cannot think of consequences, no matter how dire? 

Can we understand how attractive violence can be to certain personality structures under stress, and what severe interventions are necessary? 

Do we know how close we are to nuclear war—and a nuclear winter would dwarf the current bitter cold of the arctic vortex—even without mental instability in the president? 

The usual person has scarcely experienced the loss of mental health to any degree to be capable of imagining how critical it is as a foundation for normal political or social function, or any other human affair. This is understandable.

It is our own professional organizations that have some answering to do. A journal editor recently told me how the nation was simply waiting, upon election of Mr. Trump, for the American Psychological or American Psychiatric Association to come out and say, “These are the psychological deficiencies of the new president, of which the public needs to be aware….”

Of course, what happened was the opposite: the American Psychiatric Association converted the perfectly reasonable Goldwater rule (the guideline against diagnosing public figures without a personal examination) into a gag order (a prohibition against making any comment of any kind on a public figure) shortly after Mr. Trump’s inauguration, so that no one could speak.

The American Psychological Association then came out with its own affirmation of that position. This showed that even mental health associations are behaving more like power structures that buttress other power structures, rather than representing a medical profession. 

Not giving mental health focus to a mental health issue, regardless of where it is occurring, and controlling precisely the information that is most relevant, disempowers the public and handicaps them from responding adequately.

Individual professionals who revolted so as to use their expertise to help rather than to exclude the public have been crucial, just as they were when they fought against organizationally-sanctioned torture, but are not sufficient. There are now 37 authors in the public-service book, 

The Dangerous Case of Donald Trump, still waiting to be consulted. I was asked to lead an organization of thousands of mental health professionals who are stepping in specifically where they believe our professional associations failed in leadership, but time seems to be running out.

Raw Story: You recently held a symposium on the 25th amendment, which allows for the removal of an executive chief if they’re deemed unfit for duty. What are your thoughts on this?
Bandy X. Lee: I was merely invited—I was the only medical professional among an illustrious group of legal experts, including the original drafter of the 25th Amendment. 

The Center for Constitutional Law at the University of Akron organized the meeting. Hearing their perspectives resolved many quandaries for me and underscored the importance of having different disciplines come together in dialogue. 

This historic crisis of global proportions is beyond the ability of any one field to tackle, and too critical for politicians to go forth without expert input—from all relevant fields. Our organization is trying to bring various expertise together in March, when the second edition of our book and a new film are due for release.

For me, this experience has revealed the critical importance of presidential fitness—especially mental fitness, since mental pathology can drive a relentless pursuit for power, as well as whip up an irrational, blindly loyal following out of a hunger for adulation. 

There is no way rationality can win against this, unless we screen for it ahead of time. We notice, for example, that over a year after his last annual exam, Mr. Trump has not announced any intent to undergo another exam.

Last year, the emergency-medicine White House physician Dr. Ronny Jackson, without proper training in mental health and without the requisite independence, declared his employer and commander-in-chief “mentally fit to serve” based on a 10-minute dementia test. This is a test of such low sensitivity that full-blown Alzheimer patients and hospitalized schizophrenia patients are known to score in the normal range. 

Since then, Dr. Jackson has been relieved of his duties as the president’s personal physician, but the exam itself was never replaced, and there is no word of any new exam. Exams of mental capacity, which is a part of fitness for duty, follow standardized procedures and can be suited to any job, including the presidency. 

To do them properly, you need forensic mental health professionals, preferably a panel of them for something as important as presidential fitness.

Since we do not screen presidents the way we do military officers and especially those who handle nuclear weapons, the small proportion of dangerously disordered individuals in the population disproportionately attain positions of power and wreak havoc on the world. 

So we established a working group to form an expert panel, based purely on medical criteria, that can screen for fitness for duty—which would take care of that problem—in presidential and vice presidential candidates as well as in sitting presidents and vice presidents.

This idea originated from Drs. Nanette Gartrell and Dee Mosbacher, who have a chapter in the book. Section 4 of the 25th Amendment provides a way of removing a president who is unable to do the job, and the vice president, with the cabinet or “other body,” initiates it. 

The “other body,” which Congress can appoint, has been proposed to be of non-medical professionals, partially of medical professionals, and entirely of medical professionals. 

It is the last we are conceiving, but even further removed from Congress, in that we hope to establish it as an independent medical body that is as apolitical and nongovernmental as possible. 

It would be available for any Congress-appointed body, cabinet, vice president, or any other congressional initiative to consult, and occasionally—but not preferably—act on its own out of a professional duty to society when there is a clear medical need and no other body is acting