‘Trump derangement syndrome’ and the Goldwater rule for psychiatrists | Letter

A bill was recently introduced to the Minnesota legislature to categorise “Trump derangement syndrome” as a mental illness. The proposed bill defines the syndrome as characterised by “verbal expressions of intense hostility toward” Donald Trump and “overt acts of aggression and violence against anyone supporting [Trump] or anything that symbolises [Trump].”

Such a bill obviously infringes on our constitutional right to freely criticise our elected leaders and can serve as a stepping stone towards labelling and punishing political opponents under the guise of utilising a variety of compulsory psychiatric interventions. However, this bill is reminiscent of anti-Trump mental health professionals who have opined that President Trump poses a great danger because of a severe personality disorder.

Clearly, a psychiatric diagnosis can only be made by mental health professionals who are licensed to do so, and only after having examined a patient. It poses great danger to our society both when legislators use their political power to impose a psychiatric label on their political opponents and when mental health professionals misapply their expertise to give a psychiatric label to those whom they fear.

In the 1960s, many psychiatrists opined on the mental health of the Republican presidential candidate Barry Goldwater. As a result of that controversy, in 1973 the American Psychiatric Association developed the “Goldwater rule”, which applies to public figures. It states that it is unethical for a psychiatrist to offer a proper authorisation for such a statement.

This rule is still in effect, though much too often broken. Perhaps we need to develop a comparable national rule prohibiting political personnel, both elected and appointed, from creating psychiatric diagnoses as a tool against their political opponents.
Leon Hoffman
Psychiatrist, New York City, US