You need the right key to open a lock, and can’t be sure you have the right one unless you can try the key in the lock. So psychiatrists usually won’t make a diagnosis from afar. But sometimes a person’s behavior is unusual and problematic enough that a professional feels compelled to say something. Earlier this month, two prestigious psychiatrists sent this opinion piece into the NYT:
To the Editor:
Soon after the election, one of us raised concerns about Donald Trump’s fitness for office, based on the alarming symptoms of mental instability he had shown during his campaign. Since then, this concern has grown. Even within the space of a few weeks, the demands of the presidency have magnified his erratic patterns of behavior.
In particular, we are struck by his repeated failure to distinguish between reality and fantasy, and his outbursts of rage when his fantasies are contradicted. Without any demonstrable evidence, he repeatedly resorts to paranoid claims of conspiracy.
Most recently, in response to suggestions of contact between his campaign and agents of the Russian government, he has issued tirades against the press as an “enemy of the people” and accusations without proof that his predecessor, former President Barack Obama, engaged in partisan surveillance against him.
We are in no way offering a psychiatric diagnosis, which would be unwise to attempt from a distance. Nevertheless, as psychiatrists we feel obliged to express our alarm. We fear that when faced with a crisis, President Trump will lack the judgment to respond rationally.
The military powers entrusted to him endanger us all. We urge our elected representatives to take the necessary steps to protect us from this dangerous president.
JUDITH L. HERMAN
ROBERT JAY LIFTON, NEW YORK
Dr. Herman is a professor of psychiatry at Harvard Medical School. Dr. Lifton is a lecturer in psychiatry at Columbia University and professor emeritus at CUNY.
I’ve often wondered how mental health professionals evaluate their patients and arrive at the treatment options for them. What is taught in four years of residency, for example, that gives that young person deep insights into the mental state of another person? It seems like a short time to get (some) people tuned into what’s happening at a profound level in someone else. Anyway, in general that training is recognized as effective and these two high level practitioners sound very concerned about President Trump’s inner world and its possible negative effects on the rest of us.