By Europaeus *

Continued from Part 18

Published on 3 October 2017, The Dangerous Case of Donald Trump had been edited by professor Bandy Xenobia Lee, an American psychiatrist with Yale University School of Medicine, and contains essays from 27 psychiatrists, psychologists and other mental health professionals on the “clear and present danger” that President Trump’s mental health poses to the “nation and individual well being.” The specialists argued that the President’s mental health is affecting the mental health of the people of the United States and that he places the country at grave risk: possibly of involving it in a war and, always, of undermining democracy itself because of his pathological dangerousness. Consequently, they claimed, Trump’s presidency represents an emergency not only allowing, but perhaps also requiring, psychiatrists in the United States to raise alarms. The book contributors were able to overcome the ‘Goldwater rule’ by maintaining that pointing out danger and calling for an evaluation is different from diagnosis. Further, they have defended their decision on the ground that it is dangerous to turn reasonable ethical guidelines into a gag rule under political pressure.

The book has been very well received and highly praised, and suffice for all views that of professor Estelle B. Freedman, a historian who hold the Edgar E. Robinson Professorship in U.S. History at Stanford University. Her view is that “this insightful collection is grounded in historical consciousness of the ways professionals have responded to fascist leaders and unstable politicians in the past. It is a valuable primary source documenting the critical turning point when American psychiatry reassessed the ethics of restraining commentary on the mental health of public officials in light of the “duty to warn” of imminent danger. Medical and legal experts thoughtfully assess diagnoses of Trump’s behavior and astutely explore how to scrutinize political candidates, address client fears, and assess the ‘Trump Effect’ on our social fabric.”

One of America’s leading psycho-historians, Robert Jay Lifton, wrote the foreword to the book. Professor Lifton is renowned for his studies of people under stress – for books such as Death in Life: Survivors of Hiroshima (1967), Home from the War: Vietnam Veterans-Neither Victims nor Executioners (1973), and The Nazi Doctors: Medical Killing and the Psychology of Genocide (1986). The Nazi Doctors was the first in-depth study of how medical professionals rationalised their participation in the Holocaust, from the early stages of the Hitler’s euthanasia project to extermination camps.

The issue of the ‘duty to warn’ is so compelling that, when Dr. John D. Gartner, who practices as a clinical psychologist in New York and Baltimore, decided to set up an organisation by that name intent on warning Americans that they are in dire trouble due to their president’s mental instability, more than 60,000 mental health professionals signed a petition prepared by Dr. Gartner, which states: “We, the undersigned mental health professionals, believe in our professional judgement that Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States. And we respectfully request he be removed from office, according to article 4 of the 25th amendment to the Constitution, which states that the president will be replaced if he is ‘unable to discharge the powers and duties of his office.’ ” (Dr. John Gartner: “We Have a Duty to Warn the World About Donald Trump”, www.change.org, 22 March 2017).

At mid-September 2017 Bill Moyers, a very much respected journalist and commentator, was fortunate enough to interview professor Lifton. The long interview began with a consideration of the ethical dilemma faced by the book’s contributors: the Goldwater rule against the duty to warn.

This is how the dilemma was put to professor Lifton: “ … Aren’t you and the 26 other mental health experts who contribute to [the book] in effect violating the Goldwater Rule? … Are you putting your profession’s reputation at risk ?”

And this is how professor Lifton replied: “I don’t think so. I think the Goldwater Rule is a little ambiguous. We adhere to that portion of the Goldwater Rule that says we don’t see ourselves as making a definitive diagnosis in a formal way and we don’t believe that should be done, except by hands-on interviewing and studying of a person. But we take issue with the idea that therefore we can say nothing about Trump or any other public figure. We have a perfect right to offer our opinion, and that’s where “duty to warn” comes in.

Moyers: Duty to warn?

Lifton: We have a duty to warn on an individual basis if we are treating someone who may be dangerous to herself or to others – a duty to warn people who are in danger from that person. We feel it’s our duty to warn the country about the danger of this president. If we think we have learned something about Donald Trump and his psychology that is dangerous to the country, yes, we have an obligation to say so. (And that is why Judith Lewis Herman, professor of clinical psychiatry at Harvard University Medical School and Lifton had written a letter ‘Protect us from this dangerous president, 2 psychiatrists say’ to The New York Times, on 8 March 2017).

We argue that Trump’s difficult relationship to reality and his inability to respond in an evenhanded way to a crisis renders him unfit to be president, and we asked our elected representative to take steps to remove him from the presidency. [Emphasis added]

…

Moyers: You write in the foreword of the book: “Because Trump is president and operates within the broad contours and interactions of the presidency, there is a tendency to view what he does as simply part of our democratic process, that is, as politically and even ethically normal.”

Lifton: Yes. And that’s what I call malignant normality. What we put forward as self-evident and normal may be deeply dangerous and destructive. I came to that idea in my work on the psychology of Nazi doctors – and I’m not equating anybody with Nazi doctors, but it’s the principle that prevails – and also with American psychologists who became architects of CIA torture during the Iraq War era. These are forms of malignant normality. For example, Donald Trump lies, repeatedly. We may come to see a president as liar as normal. He also makes bombastic statements about nuclear weapons, for instance, which can then be seen as somehow normal. In other words, his behavior as president, with all those who defend his behavior in the administration, becomes a norm. We have to contest it, because it is malignant normality. For the contributors to this book, this means striving to be witnessing professionals, confronting the malignancy and making it known. [Emphasis added]

Moyers: Witnessing professionals? Where did this notion come from?

Lifton: I first came to it in terms of psychiatrists assigned to Vietnam, way back then. If a soldier became anxious and enraged about the immorality of the Vietnam War, he might be sent to a psychiatrist who would be expected to help him be strong enough to return to committing atrocities. So there was something wrong in what professionals were doing, and some of us had to try to expose this as the wrong and manipulative use of our profession. We had to see ourselves as witnessing professionals. And then of course, with the Nazi doctors I studied for another book – doctors assigned, say, to Auschwitz – they were expected to do selections of Jews for the gas chamber. That was what was expected of them and what for the most part they did – sometimes with some apprehension, but they did it. So that’s another malignant normality. Professionals were reduced to being automatic servants of the existing regime as opposed to people with special knowledge balanced by a moral baseline as well as the scientific information to make judgments.

Moyers: And that should apply to journalists, lawyers, doctors —

Lifton: Absolutely. One bears witness by taking in the situation – in this case, its malignant nature – and then telling one’s story about it, in this case with the help of professional knowledge, so that we add perspective on what’s wrong, rather than being servants of the powers responsible for the malignant normality. We must be people with a conscience in a very fundamental way. [Emphasis added]

Moyers: And this is what troubled you and many of your colleagues about the psychologists who helped implement the US policy of torture after 9/11.

Lifton: Absolutely. And I call that a scandal within a scandal, because yes, it was indeed professionals who became architects of torture, and their professional society, the American Psychological Association, which encouraged and protected them until finally protest from within that society by other members forced a change. So that was a dreadful moment in the history of psychology and in the history of professionals in this country.

Moyers: Some of the descriptions used to describe Trump — narcissistic personality disorder, antisocial personality disorder, paranoid personality disorder, delusional disorder, malignant narcissist – even some have suggested early forms of dementia – are difficult for lay people to grasp. Some experts say that it’s not one thing that’s wrong with him – there are a lot of things wrong with him and together they add up to what one of your colleagues calls “a scary witches brew, a toxic stew.”

Lifton: I think that’s very accurate. I agree that there’s an all-enveloping destructiveness in his character and in his psychological tendencies. But I’ve focused on what professionally I call solipsistic reality. Solipsistic reality means that the only reality he’s capable of embracing has to do with his own self and the perception by and protection of his own self. And for a president to be so bound in this isolated solipsistic reality could not be more dangerous for the country and for the world. In that sense, he does what psychotics do. [Emphasis added]

Psychotics engage in, or frequently engage in a view of reality based only on the self. He’s not psychotic, but I think ultimately this solipsistic reality will be the source of his removal from the presidency. [Emphasis added]

Moyers: What’s your take on how he makes increasingly bizarre statements that are contradicted by irrefutable evidence to the contrary, and yet he just keeps on making them? I know some people in your field call this a delusional disorder, a profound loss of contact with external reality.

Lifton: He doesn’t have clear contact with reality, though I’m not sure it qualifies as a bona fide delusion. He needs things to be a certain way even though they aren’t, and that’s one reason he lies. There can also be a conscious manipulative element to it. When he put forward, and politically thrived on, the falsehood of President Obama’s birth in Kenya, outside the United States, he was manipulating that lie as well as undoubtedly believing it in part, at least in a segment of his personality. In my investigations, I’ve found that people can believe and not believe something at the same time, and in his case, he could be very manipulative and be quite gifted at his manipulations. So I think it’s a combination of those. [Emphasis added]

Moyers: How can someone believe and not believe at the same time?

Lifton: Well, in one part of himself, Trump can know there’s no evidence that Obama was born in any place but Hawaii in the United States. But in another part of himself, he has the need to reject Obama as a president of the United States by asserting that he was born outside of the country. He needs to delegitimate Obama. That’s been a strong need of Trump’s. This is a personal, isolated solipsistic need which can coexist with a recognition that there’s no evidence at all to back it up. I learned about this from some of the false confessions I came upon in my work.

Moyers: Where?

Lifton: For instance, when I was studying Chinese communist thought reform, one priest was falsely accused of being a spy, and was under physical duress – really tortured with chains and in other intolerable ways. As he was tortured and the interrogator kept insisting that he was a spy, he began to imagine himself in the role of a spy, with spy radios in all the houses of his order. In his conversations with other missionaries he began to think he was revealing military data to the enemy in some way. These thoughts became real to him because he had to, entered into them and convinced the interrogator that he believed them in order to remove the chains and the torture. He told me it seemed like someone creating a novel and the novelist building a story with characters which become real and believable. Something like that could happen to Trump, in which the false beliefs become part of a narrative, all of which is fantasy and very often bound up with conspiracy theory, so that he immerses himself in it and believing in it even as at the same time recognizing in another part of his mind that none of this exists. The human mind can do that.

Moyers: It’s as if he believes the truth is defined by his words.

Lifton: Yes, that’s right. Trump has a mind that in many ways is always under duress, because he’s always seeking to be accepted, loved. He sees himself as constantly victimized by others and by the society, from which he sees himself as fighting back. So there’s always an intensity to his destructive behavior that could contribute to his false beliefs.

Moyers: Do you remember when he tweeted that President Obama had him wiretapped, despite the fact that the intelligence community couldn’t find any evidence to support his claim? And when he spoke to a CIA gathering, with the television cameras running, he said he was “a thousand percent behind the CIA,” despite the fact that everyone watching had to know he had repeatedly denounced the “incompetence and dishonesty” of that same intelligence community.

Lifton: Yes, that’s an extraordinary situation. And one has to invoke here this notion of a self-determined truth, this inner need for the situation to take shape in the form that the falsehood claims. In a sense this takes precedence over any other criteria for what is true.

Moyers: What other hazardous patterns do you see in his behavior? For example, what do you make of the admiration that he has expressed for brutal dictators – Bashar al-Assad of Syria, the late Saddam Hussein of Iraq, even Kim Jong Un of North Korea – yes, him – and President Rodrigo Duterte of the Philippines, who turned vigilantes loose to kill thousands of drug users, and of course his admiration for Vladimir Putin. In the book Michael Tansey says, “There’s considerable evidence to suggest that absolute tyranny is Donald Trump’s wet dream.”

Lifton: Yes. Well, while Trump doesn’t have any systematic ideology, he does have a narrative, and in that narrative, America was once a great country, it’s been weakened by poor leadership, and only he can make it great again by taking over. And that’s an image of himself as a strongman, a dictator. It isn’t the clear ideology of being a fascist or some other clear-cut ideological figure. Rather, it’s a narrative of himself as being unique and all-powerful. He believes it, though I’m sure he’s got doubts about it. But his narrative in a sense calls forth other strongmen, other dictators who run their country in an absolute way and don’t have to bother with legislative division or legal issues.

Moyers: I suspect some elected officials sometimes dream of doing what an unopposed autocrat or strongman is able to do, and that’s demand adulation on the one hand, and on the other hand, eradicate all of your perceived enemies just by turning your thumb down to the crowd. No need to worry about “fake media” – you’ve had them done away with. No protesters. No confounding lawsuits against you. Nothing stands in your way.

Lifton: That’s exactly right. Trump gives the impression that he would like to govern by decree. And of course, who governs by decree but dictators or strongmen? He has that impulse in him and he wants to be a savior, so he says, in his famous phrase, “Only I can fix it!” That’s a strange and weird statement for anybody to make, but it’s central to Trump’s sense of self and self-presentation. And I think that has a lot to do with his identification with dictators. No matter how many they kill and no matter what else they do, they have this capacity to rule by decree without any interference by legislators or courts. [Emphasis added]

In the case of Putin, I think Trump does have involvements in Russia that are in some way determinative. I think they’ll be important in his removal from office. I think he’s aware of collusion on his part and his campaign’s, some of which has been brought out, a lot more of which will be brought out in the future. He appears to have had some kind of involvement with the Russians in which they’ve rescued him financially and maybe continue to do so, so that he’s beholden to them in ways for which there’s already lots of evidence. So I think his fierce impulse to cover up any kind of Russian connections, which is prone to obstruction of justice, will do him in.

Continued tomorrow … (Part 20)

* Europaeus landed in Australia over fifty years ago. Except for the blue skies and starry nights between 02.12.1972 and 10.11.1975 the place has been constantly overwhelmed by what Hannah Arendt called the ‘sand storm’ – a metaphor for totalitarianism.