Leonard L. Glass, MD, is a BPSI Psychoanalyst Member. His below remarks originally appeared in the Spring-Summer 2020 issue of the BPSI Bulletin, which can be read here.
For me, it began with reading and responding to posts on the American Psychoanalytic Association Members’ Listserv. Analytic colleagues were reacting to the candidacy and, later, the presidency of Donald Trump. They had a variety of opinions, sometimes stated with nuance, but often not. Others objected to this dialogue, feeling it was improper and irresponsible for analysts to be speaking out when doing so, it seemed to them, was predicated on the mistaken assumption that psychoanalysis had anything plausibly unique or authoritative to say. In addition, they worried it might risk alienating patients and undermining the field’s credibility vis-à-vis our own more narrowly defined domain (a credibility, fairly pointed out, that has already been under siege.)
The question of the validity of such writing persists to this day, even if the divergence of opinions regarding the current President has all but disappeared in the analytic community. While the prior question of the legitimacy and appropriateness of such writing remains controversial, I will set that aside for now and address the issue of “how” to undertake this task. Whether this is a legitimate thing to do will be addressed in October, on the cusp of the election, with an Explorations in Mind class on Zoom, open to all.
Why do it? Why Write about the Mental Fitness of Trump?
Put simply, for some of us there is no other acceptable choice. While the American Psychiatric Association (and its sister institutions for psychology and social work) prohibits speaking about a “patient” without an in-person examination and the “patient’s authorization,” a number of us have argued that there is no patient when speaking of a public figure (unless, of course, that person happens to be your patient), and hence those duties are not owed. Further, despite the threat of ethical violation spelled out in the Goldwater Rule, we who have chosen to write, believe that duties of conscience override the importance of protecting “the guilds” from the potential of bad publicity. It struck us that silence was complicity and, if it isn’t our role to point out dangerous qualities in the mental make-up of a powerful figure, whose is it?
What Lexicon Should Be Used?
A unique challenge for the analytic practitioner writing for a lay audience, say, in an op-ed for the Boston Globe, is the need to strike a balance between sounding professionally competent without obfuscating. It has been observed that, particularly in analytic literature, the harder it is for the reader to comprehend an article, the smarter the author is assumed to be! On the other hand, one doesn’t want to sound condescending or underestimate the intelligence of the reading public. Editors are sensitive to matters of language and tone: it’s what they do for a living.
So, we have to use language that is accessible without being pedestrian; we have to be illuminating and insightful without being couched in jargon or showing too much satisfaction in our own sectarian brilliance. For example, rather than writing, “Trump has a narcissistic core defended by externalization verging on psychotic distortion,” one could say, “Trump is thin-skinned and protects himself from confronting evidence of his failures by blaming others and distorting the factual basis for valid criticisms.” Yes, many more words when you’re not using our coded lingo, but much more accessible and less of a turn-off for the average reader. I also had the advantage of writing with a behaviorist and a forensic psychiatrist—they took exception if I ventured into intrapsychic territory! We focused on the issue of fitness to serve as president, basing our observations on the abundance of publicly available evidence Trump presents in his videotaped speeches and real time reactions. We chose to avoid diagnostic speculation, though other colleagues have not refrained.
Does the Public Need Mental Health Professionals to State “the Obvious?”
This is surely arguable and takes us back to the first question: is such writing necessary and valid? Here I would make two points: (1) what is “obvious” to many mental health professionals effectively eluded the understanding and/or acceptance of nearly half of the voting public in 2016; and, (2) when unchecked power is concentrated in the hands of a willfully ignorant, impulsive, and vengeful man devoid of empathy, it’s worth the risk to restate the obvious, lest anyone who is at all open to the discernment of mental health experts remain in doubt. And, candidly, here’s a third reason: what will we tell our grandchildren regarding our actions at this perilous moment if we remain silent?
How Do You Get Your Piece Published?
On the one hand, this is the hardest part mechanically: we are used to the routine of writing for learned journals, not the lay press. And these days, unsolicited submissions to surviving mainstream print publications vastly outnumber the space available. But, on the other hand, the universe of publications, especially online publications, has multiplied exponentially in the past decade. Even mainstream newspapers like the New York Times “publishes” many more op-eds and letters online than in their print editions. And there are many other online and print outlets: Psychology Today, Politico, The Hill, STAT News, to name a few, not to mention the BPSI Bulletin! If you let people know you’re interested and available, you may get invited to write something or appear on a radio or television program. And, don’t forget, you can always trial your ideas on the American Psychoanalytic Association Members’ Listserv!
Harris, B., Dr, & Zucker, S., Dr. (2011, October 1). Caravaggio, Narcissus at the Source. Click here to watch on YouTube.
Leonard L. Glass, MD, is a Psychoanalyst Member and Past President at the Boston Psychoanalytic Society and Institute. He is also an Associate Professor of Psychiatry (Part-time) at Harvard Medical School and a senior attending psychiatrist at McLean Hospital. His earlier post Dealing with American Psychiatry’s Gag Rule published by the Boston Globe and posted on the BPSI blog in 2017 can be read here.
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