In service to a psychotic delusional raging narcissist

Sadly, Bandy Lee’s The Dangerous Case of Donald Trump^[1] is one of many books that sits on my shelf, unread, because I’m so busy trying to keep my head above water driving for Uber and Lyft that I cannot take time to catch up on reading that I’ve thought important.^[2]

I follow her on Twitter and it was in this way that I learned that she’d been fired from Yale University. As Len Gutkin summarizes the case,

Bandy X. Lee, a psychiatrist, has been dropped from her teaching position at Yale for suggesting, on Twitter, that Donald J. Trump’s associates developed a distorted vision of reality in concert with the former president. Lee leveled the diagnosis of “shared psychosis” specifically at Alan M. Dershowitz. Dershowitz wrote a letter to Yale insisting that Lee had violated the American Psychiatric Association’s prohibition on diagnosing public figures without examining them. Yale fired Lee. She is suing.^[3]

Gutkin is sympathetic, raising issues of academic freedom but also,

The discourse of scientific validity, though, might be thought to cut the other way. If “shared psychosis” is a real thing, there’s no obvious reason why, in the case of constantly televised public figures like Trump and his circle, one would need to meet with them in a doctor’s office to diagnose it. There’s no obvious reason, even, that one would need to be a psychiatrist. Gravity is real; I observe its operations every day, and I don’t need to be a physicist to know what I’m seeing. Is it possible that, by over-insisting on the need for special professional paraphernalia (the doctor’s visit and so on) to recognize the objects it studies, the discipline of psychiatry is actually undermining its claims to authority?^[4]

I am sympathetic as well, having repeatedly referred to Donald Trump as the (now-former) delusional raging narcissist-in-chief. There simply can be no question that Trump’s falsehoods on hydroxychloroquine and bleach and his diminishing of COVID-19 in general have cost many hundreds of thousands of lives in a pandemic whose toll in the U.S., as of early this morning, has reached 554,579.^[5] His behavior matches descriptions of narcissistic rage^[6] and of psychosis.^[7] He and his followers exhibit an addiction to grievance^[8] and his niece, herself a psychologist who has authored her own assessment,^[9] says, “He’s never been in a situation in which he has lost in a way he can’t escape from,” while Lee affirms that Trump is incapable of accepting reality.^[10] None of this should be even remotely controversial and is only so if, like Alan Dershowitz, you are a partisan on Trump’s behalf.

But Yale fired Lee.

At stake in the so-called Goldwater Rule, then, is psychiatry’s pretension to scientific objectivity, untainted by the political or ideological predispositions of its practitioners. As Jeffrey Lieberman, chair of the psychiatry department at Columbia, told The New York Times, Lee’s tweets are “problematic for the profession, because it means the profession is using terms too loosely and too glibly. It’s just kind of using a word, a term, that has a clinical meaning and also conveys or connotes a certain level of severity of mental disturbance in a way that’s really inappropriate.”^[11]

Lee answers this charge by citing a “duty to warn,” that the avoidance of harm to the general public outweighs any damage to Trump, certainly that to the profession of psychiatry, the latter being what the Goldwater Rule is all about.

Gutkin’s brief in the Chronicle of Higher Education doesn’t quite knit the logic of his suggestion that “the discipline of psychiatry is actually undermining its [own] claims to authority”^[12] together. He’s right, though, because indeed we do not need to be physicists to observe the operation of gravity. Indeed, to quantify it, to my dismay, I need only step on a scale.

Similarly, that Trump posed a harm to the public can hardly be in dispute. Except, of course, if you are like Dershowitz. Or, apparently, Yale University.

Here, Gutkin’s poorly knit together concluding suggestion is on point. Psychiatry damages itself. Yale damages itself. The discipline and the university act in service to a delusion promulgated by a psychotic delusional raging narcissist and they endanger the public in so doing. That’s not what any of us are here for.

1. ^[1]Bandy Lee, ed., The Dangerous Case of Donald Trump (New York: Saint Martin’s, 2017).↩
2. ^[2]David Benfell, “About my job hunt,” Not Housebroken, n.d., https://disunitedstates.org/about-my-job-hunt/↩
3. ^[3]Len Gutkin, “Shared Psychosis; Academic Psychiatry; Academic Freedom,” Chronicle of Higher Education, April 5, 2021, https://www.chronicle.com/newsletter/chronicle-review/2021-04-05↩
4. ^[4]Len Gutkin, “Shared Psychosis; Academic Psychiatry; Academic Freedom,” Chronicle of Higher Education, April 5, 2021, https://www.chronicle.com/newsletter/chronicle-review/2021-04-05↩
5. ^[5]New York Times, “Coronavirus in the U.S.: Latest Map and Case Count,” April 5, 2021, https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html↩
6. ^[6]George Simon, “Understanding and Dealing with Narcissistic Rage,” Counselling Resource, July 24, 2017, https://counsellingresource.com/features/2017/07/24/understanding-narcissistic-rage/↩
7. ^[7]WebMD, “Psychosis and Psychotic Episodes,” July 13, 2019, https://www.webmd.com/schizophrenia/guide/what-is-psychosis#1↩
8. ^[8]James Kimmel, Jr., “What the Science of Addiction Tells Us About Trump,” Politico, December 12, 2020, https://www.politico.com/news/magazine/2020/12/12/trump-grievance-addiction-444570↩
9. ^[9]Mary L. Trump, Too Much and Never Enough (New York: Simon and Schuster, 2020).↩
10. ^[10]Michael Kruse, “Is Trump Cracking Under the Weight of Losing?” Politico, December 20, 2020, https://www.politico.com/news/magazine/2020/12/20/trump-white-house-losing-448903↩
11. ^[11]Len Gutkin, “Shared Psychosis; Academic Psychiatry; Academic Freedom,” Chronicle of Higher Education, April 5, 2021, https://www.chronicle.com/newsletter/chronicle-review/2021-04-05↩
12. ^[12]Len Gutkin, “Shared Psychosis; Academic Psychiatry; Academic Freedom,” Chronicle of Higher Education, April 5, 2021, https://www.chronicle.com/newsletter/chronicle-review/2021-04-05↩