Tuesday, August 15, 2017

On the "Goldwater Rule"

The trouble with personality disorders is lack of representation, and this comes from a deep-seeded problem in their sufferers, a lack of introspection. This comes, as we have discussed before, from the disorders being ego-syntonic, or rather, the thoughts, feelings, and behaviors exhibited by their sufferers are in tune with the wants and needs of their ego. This is a stark contrast to disorders like Obsessive-Compulsive Disorder which are ego-dystonic, where the sufferer recognizes they have a problem, are troubled by it, and want help coping with it. When there is lack of introspection to one's own problems, this can lead to lack of representation for that community, leaving the only figureheads for their plight to be the worst case scenarios which bubble to the top. As much as I would like to avoid this discussion all together, it is time for us to talk about Donald Trump.

Love him or hate him, one cannot ignore that his fitness for holding public office has become a subject of scrutiny, with some in the media having discussions over whether or not he has an underlying mental illness which is not being discussed. Recently, on a Sirius XM broadcast of the program, Radio Times, there was debate over what is referred to as the Goldwater Rule of psychology. Before we dive any deeper into the debate over President Trump's mental state, it is important to understand what the Goldwater Rule is, and that brings us back in time to the presidential election bid of one Barry Goldwater, a man whom Fact magazine ran a headline about, in 1964, stating, "fact: 1,189 Psychiatrists Say Goldwater Is Psychologically Unfit To Be President!"

Now, that is an alarming headline, even if the man in question did look like the antagonist from Dr. Strangelove. What is alarming about the headline is not necessarily the number of people involved, but rather the idea of whether or not psychologists should be able to diagnose people from afar, specifically people in the public sphere. The affectionately dubbed "Goldwater Rule" was set in place by the APA (American Psychiatric Association) to dissuade their members from doing just that since the practice could have mixed results. The purpose of meeting with a person in a private setting is to properly gauge someone from an intimate perspective so as to help them from the root causes of their problems. When diagnosing someone from afar, there is none of that.

The purpose, instead, becomes a position of moral imperative, such as to warn the public of someone's fitness for public office. This was the case with Barry Goldwater and continues to be the case with Donald Trump. Through the election cycle, I was bombarded with news commentators bringing psychologists onto their shows and asking them very specific questions about Trump's mental state. Now, at full disclosure, I am not a fan of Donald Trump, and were it not for accident of birth, I would have happily lived my life never once setting foot in the same time zone as the man, but here we are. More disclosure, I am, as we have discussed, professionally diagnosed with two personality disorders and traits of a third, one of the three being the subject of discussion around the president; that one being Narcissistic Personality Disorder (NPD).

That being said, let us move on to the Radio Times broadcast. One of the guests on the program, psychologist John Gartner, made the case against the Goldwater Rule, discussing how moral imperative was key when it came to Donald Trump, and for that, I cannot necessarily fault him entirely. Our president, in my own opinion, is the human embodiment of menstruation with a personality which can best be described as the awkward meeting between a person who wants to shake hands and another who wants to fist bump, resulting in an unpleasant orgy of fingers.

That, however, is where my agreements with Gartner cease and where our disagreements begin. He makes the argument that if only psychologists had been able to warn the public about Trump's mental state and how it would only get worse, then we would not be in the situation we are now. I do not see the viability of that strategy given that this pertains to a man who claimed he could shoot a man in broad daylight without losing any support, and then, did everything short of shooting a man in broad daylight without losing any support. If recorded statements about sexual assault do not make people second guess a candidate for office, then saying he is mentally unfit is probably not going to do much either.

Offering a differing opinion from Gartner was science writer Christie Aschwanden, who posed the question, what is the point in even giving Trump the diagnosis of NPD, which Gartner showed support for? Gartner argues that had he been given a diagnosis, Trump would have been less appealing to voters, but as I just mentioned, I do not entirely view that as true. People who already supported him would have more than likely written off the diagnosis as "fake news," while people who were already against him would have probably just spammed the link to his diagnosis on Facebook with the caption, "IMPORTANT!!! PLS READ!!1!"

At this point, giving Donald Trump a diagnosis is far less about making sure he finds some sort of help for a condition and more about losing him support among the voting public, which brings us back to the beginning. Where there is lack of representation, the worst case examples of a group will become the figureheads of a community. Take Schizophrenia for example. Before there was better representation for the disorder, it was demonized (and still is to a large degree), and its sufferers were thought to be dangerous, blood-thirsty monsters. As time has passed, we learned that mathematicians like John Nash, writers like Jack Kerouac, and musicians like Syd Barrett all spent their lives combating this demon, and while there is a lot of room to go in public consciousness about Schizophrenia, as well as getting treatment to those who need it and do not have access, things have undoubtedly gotten better.

When discussing NPD and Trump, he has become a boogeyman for the disorder. Even the man who wrote the criteria for NPD in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), psychiatrist Allen Frances, disagrees with giving Trump the diagnosis, because, as Frances puts it, Trump lacks the distress and impairment which qualify him as having a mental disorder. This is a point which must be understood, because distress and impairment are the key difference between a person diagnosed with OCD who washes their hands until they bleed and a person who thinks it is fun to say they are "OCD" because they do their laundry at 1 in the morning. Just because you experience something out of the norm or just because you experience something unpleasant on the same level as everyone else in the human race does not mean you have a disorder, and it certainly does not mean psychology is turning any quirk into a disorder.

Everyone may feel depressed at times, but they do not all have depression. Likewise, you may feel great about yourself at times, you may forget to tend to the needs of others, and you may even feel entitled at times. None of this means you are a textbook example of NPD. Living with NPD means constantly avoiding any endeavor that you are not already excelling at out of an intense fear that others will mock you or laugh at you when you mess up, which you perceive will inevitably happen. It means if you are not the best at everything, then you view life as meaningless, and it would be better if you were dead. It means that you have to be perfect, and if you are not perfect, then you have to change whatever about yourself is imperfect, even if it means starving yourself, clawing at your skin to remove a blemish, or working out until you are so weak that you cannot even stand up under your own weight.

Call Trump a narcissist, by all means. He has proven time and again that self-interest is big on his list, but do not use my disorder to demonize someone whose actions do that for him already. The man's sub-headers on his Wikipedia page are far more ammunition against him than a diagnosis of NPD ever could be. Gartner goes on to say that people with this type of illness, either Narcissistic Personality Disorder or a personality disorder in general (he did not specify), would never admit they have a disorder, later saying, "These types of people are severely dangerous," which is, in itself, a dangerous statement.

To say "these types of people," meaning those with personality disorders, or more specifically NPD, are "severely dangerous," is, in itself, dangerous because within the larger falsehood is a grain of truth. Ignoring Garnter's other idea that we can look back at history and assess these disorders in world leaders who are long dead, there have in fact been recorded cases where persons with personality disorders have committed horrible crimes, Anders Breivik and Aileen Wuornos just to name a few. These were people who carried out premeditated attacks on innocent people, but to label an entire disorder or category of disorders as being dangerous puts a target on the back of anyone with those disorders. It dehumanizes the people with personality disorders to a degree that makes it seem that if anything unfortunate were to befall them, then...they were probably asking for it.

I cannot speak for all people with personality disorders out there. Many of them would probably rather speak for themselves, but I do my best in dispelling the myths surrounding this community, and what does not help that crusade is being labelled dangerous. This is hardly the only argument posed against those with personality disorders, and it is not entirely without reason. You look at the criteria of any given personality disorder, and it does not paint a pretty picture, especially those in Cluster B, but as I have discussed before, a diagnosis of this sort does not make you a bad person. As I have said before, when you are born, you are given a toolbox: your brain.

In the average toolbox, you are given a hammer, some nails, a measure, and other helpful tools at your disposal. With a personality disorder, your toolbox is a bit darker, featuring duct tape, zip ties, and a hacksaw, but these are just tools. You can see what you are given and follow some cookie cutter pattern laid out before you, or your can get creative. Life is not the sum of the tools which you are given; it is how you use them that determines what kind of person you are. Life is not a pool of good and evil people. It is a pool of right and wrong decisions, which you and you alone have to make, and surprise, no one is all of one or the other. Everyone is a mixture of both. Everyone.

No matter what someone says, your diagnosis does not make you a bad person. That is for you to determine. I, myself, am a self-absorbed, greedy, sinful, emotionally unstable, impulsive, angry, unempathetic, self-destructive human being. Despite all of that, I am alive, I have friends, I go on dates, I have a steady job, and live life to the fullest each and every day. I may need help from those in my life, both professional and intimate, but I am still alive. I am trying to get by, and while I may need more help than the average person, I am still trying.

I have a fight going on in my head, between doing what is right and doing what is easy, doing what is self-serving, doing what feeds my own delusions. This fight is difficult, this fight is real, and this fight is now a part of the public discourse but not in anyway that benefits those with personality disorders. The scary part about the whole situation is that the only way we can combat these perceptions of persons with these disorders as being dangerous is to step out of the shadows and tell the world otherwise.

I have often lived with the fear of being open about my mental illness, knowing the connotations those diagnoses carry, especially having seen those with better understood disorders than my own be ostracized by society. It is a taint on my soul which tears at my already fragile sense of perfection. Donald Trump is not and should not be the face of a disorder which he has not even been diagnosed to have. The diagnosis of a psychological disorder is not a label you should use to tear down those you disagree with. It is the tool which many of us use to begin the long journey to self discovery. 


  1. The thing that gets my jimmies rustling is the fact that virtually every politician is, to some degree, narcissistic. But people conflate traits with having the full PD, and then assume that traits = having the whole thing. I will freely admit I voted for Trump on the basis of not-Hillary, but I'm also freely willing to admit that he's basically the poster-child for impulsivity. Despite this, I'd never make the claim he has NPD (or ASPD for the impulsivity, for that matter), though the group I align with most closely does have a tendency to call everybody psychopaths when they're clearly not.