In Donald Trump, we have a frightening Venn diagram consisting of three circles: the first is extreme present hedonism; the second, narcissism; and the third, bullying behavior.
These three circles overlap in the middle to create an impulsive, immature, incompetent person who, when in the position of ultimate power, easily slides into the role of tyrant, complete with family members sitting at his proverbial “ruling table.”
Like a fledgling dictator, he plants psychological seeds of treachery in sections of our population that reinforce already negative attitudes.
To drive home our point, here are what we consider to be two of Trump’s most dangerous quotes:
• “If she gets to pick her judges, nothing you can do, folks. Although the Second Amendment people—maybe there is, I don’t know” (remark made during a campaign rally in Wilmington, North Carolina, August 9, 2016); and
• “I could stand in the middle of Fifth Avenue, shoot somebody, and I wouldn’t lose any voters” (remark made during a campaign appearance in Sioux City, Iowa, January 23, 2016).
Before Donald Trump, it was unfathomable for American citizens to consciously consider voting for, and then inaugurating, a person as unbalanced as this president.
Admittedly, it’s possible, as Guy Winch points out in his February 2, 2016, Psychology Today article, “Study: Half of All Presidents Suffered from Mental Illness.” According to Winch, many of our previous presidents may have suffered from mental health issues, including depression (Abraham Lincoln), bipolar disorder (Lyndon Johnson), alcoholism (Ulysses S. Grant), Alzheimer’s disease (Ronald Reagan), and transient bouts of extreme present hedonism (John F. Kennedy and Bill Clinton). We have also survived a president who blatantly lied to cover his criminal tracks before he was caught in those lies (Richard Nixon).
In the past, Americans have pulled together and worked to overcome our differences. We moved forward collectively as one great country. Unfortunately, in more recent times, it appears we have become a bipolar nation, with Donald Trump at the helm as his followers cheer him on and others try to resist him.
However, the lack of such tests cannot erase the well-documented behaviors he has displayed for decades and the dangers they pose when embodied in the president of the United States.
In line with the principles of Tarasoff v. Regents of the University of California 17 Cal. 3d 425 (1976), known as the “Tarasoff doctrine,” it is the responsibility of mental health professionals to warn the citizens of the United States and the people of the world of the potentially devastating effects of such an extreme present-hedonistic world leader, one with enormous power at his disposal.
On the whole, mental health professionals have failed in their duty to warn, in a timely manner, not only the public but also government officials about the dangers of President Donald Trump.
Articles and interviews intent on cautioning the masses prior to the election fell on deaf ears, perhaps in part because the media did not afford the concerned mental health professionals appropriate coverage, perhaps because some citizens discount the value of mental health and have thrown a thick blanket of stigma over the profession, or perhaps because we as mental health professionals did not stand united. Whatever the reason, it’s not too late to follow through.
We are not trying to speculate diagnoses from afar, but comparing video interviews of Trump from the 1980s, 1990s, and early 2000s to current video, we find that the differences (significant reduction in the use of essential words; an increase in the use of adjectives such as very, huge, and tremendous; and incomplete, run-on sentences that don’t make sense and that could indicate a loss of train of thought or memory) are conspicuously apparent. Perhaps this is why Trump insists on being surrounded by family members who love and understand him rather than seasoned political advisers, who may note, and then leak, his alarming behavior.
We believe that Donald Trump is the most dangerous man in the world! A powerful leader of a powerful nation who can order missiles fired at another nation because of his (or a family member’s) personal distress at seeing sad scenes of people having been gassed to death.
We shudder to imagine what actions might be taken in broader lethal confrontations with his personal and political enemies. We are gravely concerned about Trump’s abrupt, capricious 180-degree shifts and how these displays of instability have the potential to be unconscionably dangerous to the point of causing catastrophe, and not only for the citizens of the United States.
There are two particularly troubling examples:
1. His repeatedly lavishing praise on FBI director James Comey’s handling of an investigation into Hillary Clinton’s emails and then, in early May 2017, abruptly and abusively firing Comey for the very investigation that garnered such praise, but in this case actually because of Comey’s investigation into the Trump campaign’s ties to Russia; and
2 His stating during the campaign that NATO was obsolete and then, later, unexpectedly stating that NATO was necessary and acceptable.
As is the case with extreme present hedonists, Trump is “chumming” for war, possibly for the most selfish of reasons: to deflect attention away from the Russia investigation.
If another unbalanced world leader takes the bait, Trump will need the formerly “obsolete” and now-essential NATO to back him up.
We as individuals don’t have to follow our nation’s leader down a path headed in the wrong direction, off a cliff and into a pit of past mistakes. We can stand where we are at this moment in history and face forward, into a brighter future that we create. We can start by looking for the good in one another and for the common ground we share.
In the midst of the terrorist attacks on places of worship and cemeteries mentioned earlier, something wonderful emerged from the ashes: a spirit of overwhelming goodness in humanity. In the wake of the attacks, Jews and Muslims united: they held fund-raisers to help each other repair and rebuild; they shared their places of worship so that those burned out of theirs could hold gatherings and services; and they offered loving support to those who’d faced hatred.
By observing ordinary people engaging in acts of everyday heroism and compassion, we have been able to witness the best aspects of humanity. That’s us! That’s the United States of America!
A final suggestion for our governmental leaders: corporations and companies vet their prospective employees. This vetting process frequently includes psychological testing in the form of exams or quizzes to help the employer make more informed hiring decisions and determine if the prospective employee is honest and/or would be a good fit for the company.
These tests are used for positions ranging from department store sales clerk to high-level executive. Isn’t it time that the same be required for candidates for the most important job in the world?
get it at Amazon.com
Our Witness to Malignant Normality
ROBERT JAY LIFTON, M.D.
Concerning malignant normality, we start with an assumption that all societies, at various levels of consciousness, put forward ways of viewing, thinking, and behaving that are considered desirable or “normal.”
Yet, these criteria for normality can be much affected by the political and military currents of a particular era. Such requirements may be fairly benign, but they can also be destructive to the point of evil.
I came to the idea of malignant normality in my study of Nazi doctors. Those assigned to Auschwitz, when taking charge of the selections and the overall killing process, were simply doing what was expected of them. True, some were upset, even horrified, at being given this task. Yet, with a certain amount of counseling—one can call it perverse psychotherapy—offered by more experienced hands, a process that included drinking heavily together and giving assurance of help and support, the great majority could overcome their anxiety sufficiently to carry through their murderous assignment.
This was a process of adaptation to evil that is all too possible to initiate in such a situation. Above all, there was a normalization of evil that enhanced this adaptation and served to present participating doctors with the Auschwitz institution as the existing world to which one must make one’s adjustments.
There is another form of malignant normality, closer to home and more recent. I have in mind the participation in torture by physicians (including psychiatrists), and by psychologists, and other medical and psychological personnel. This reached its most extreme manifestation when two psychologists were revealed to be among architects of the CIA’s torture protocol. More than that, this malignant normality was essentially supported by the American Psychological Association in its defense of the participation of psychologists in the so-called “enhanced interrogation” techniques that spilled over into torture.
I am not equating this American behavior with the Nazi example but, rather, suggesting that malignant normality can take different forms. And nothing does more to sustain malignant normality than its support from a large organization of professionals.
There is still another kind of malignant normality, one brought about by President Trump and his administration. Judith Herman and I, in a letter to the New York Times in March 2017, stressed Trump’s dangerous individual psychological patterns: his creation of his own reality and his inability to manage the inevitable crises that face an American president.
He has also, in various ways, violated our American institutional requirements and threatened the viability of American democracy. Yet, because he 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.
In this way, a dangerous president becomes normalized, and malignant normality comes to dominate our governing (or, one could say, our antigoverning) dynamic.
But that does not mean we are helpless. We remain a society with considerable openness, with institutions that can still be life-enhancing and serve truth. Unlike Nazi doctors, articulate psychological professionals could and did expose the behavior of corrupt colleagues and even a corrupt professional society. Investigative journalists and human rights groups also greatly contributed to that exposure.
As psychological professionals, we are capable of parallel action in confronting the malignant normality of Trump and his administration. To do so we need to combine our sense of outrage with a disciplined use of our professional knowledge and experience.
This brings me to my second theme: that of witnessing professionals, particularly activist witnessing professionals. Most professionals, most of the time, operate within the norms (that is, the criteria for normality) of their particular society. Indeed, professionals often go further, and in their practices may deepen the commitment of people they work with to that normality. This can give solace, but it has its perils.
It is not generally known that during the early Cold War period, a special governmental commission, chaired by a psychiatrist and containing physicians and social scientists, was set up to help the American people achieve the desired psychological capacity to support U.S. stockpiling of nuclear weapons, cope with an anticipated nuclear attack, and overcome the fear of nuclear annihilation. The commission had the task, in short, of helping Americans accept malignant nuclear normality.
There have also been parallel examples in recent history of professionals who have promoted equally dangerous forms of normality in rejecting climate change. But professionals don’t have to serve these forms of malignant normality. We are capable of using our knowledge and technical skills to expose such normality, to bear witness to its malignance—to become witnessing professionals.
When I did my study of Hiroshima survivors back in 1962, I sought to uncover, in the most accurate and scientific way I could, the psychological and bodily experience of people exposed to the atomic bomb. Yet, I was not just a neutral observer. Over time, I came to understand myself as a witnessing professional, committed to making known what an atomic bomb could do to a city, to tell the world something of what had happened in Hiroshima and to its inhabitants. The Hiroshima story could be condensed to “one plane, one bomb, one city.” I came to view this commitment to telling Hiroshima’s story as a form of advocacy research. That meant combining a disciplined professional approach with the ethical requirements of committed witness, combining scholarship with activism.
I believe that some such approach is what we require now, in the Trump era. We need to avoid uncritical acceptance of this new version of malignant normality and, instead, bring our knowledge and experience to exposing it for what it is. This requires us to be disciplined about what we believe we know, while refraining from holding forth on what we do not know. It also requires us to recognize the urgency of the situation in which the most powerful man in the world is also the bearer of profound instability and untruth.
As psychological professionals, we act with ethical passion in our efforts to reveal what is most dangerous and what, in contrast, might be life-affirming in the face of the malignant normality that surrounds us.
Finally, there is the issue of our ethical behavior. We talk a lot about our professional ethics having to do with our responsibility to patients and to the overall standards of our discipline. This concern with professional ethics matters a great deal. But I am suggesting something more, a larger concept of professional ethics that we don’t often discuss: including who we work for and with, and how our work either affirms or questions the directions of the larger society. And, in our present situation, how we deal with the malignant normality that faces us.
This larger ethical model applies to members of other professions who may have their own “duty to warn.” I in no way minimize the significance of professional knowledge and technical skill. But our professions can become overly technicized, and we can be too much like hired guns bringing our firepower to any sponsor of the most egregious view of normality.
We can do better than that. We can take the larger ethical view of the activist witnessing professional. Bandy Lee took that perspective when organizing the Yale conference on professional responsibility, and the participants affirmed it. This does not make us saviors of our threatened society, but it does help us bring our experience and knowledge to bear on what threatens us and what might renew us.
A line from the American poet Theodore Roethke brings eloquence to what I have been trying to say: “In a dark time, the eye begins to see.”
Professions and Politics
JUDITH LEWIS HERMAN, M.D., and
BANDY X. LEE, M.D., M.DIV.
Soon after the presidential election of 2016, alarmed by the apparent mental instability of the president-elect, we both separately circulated letters among some of our professional colleagues, expressing our concern. Most of them declined to sign. A number of people admitted they were afraid of some undefined form of governmental retaliation, so quickly had a climate of fear taken hold.
They asked us if we were not wary of being “targeted,” and advised us to seek legal counsel. This was a lesson to us in how a climate of fear can induce people to censor themselves.
Others who declined to sign our letters of concern cited matters of principle. Psychiatry, we were warned, should stay out of politics; otherwise, the profession could end up being ethically compromised. The example most frequently cited was that of psychiatrists in the Soviet Union who collaborated with the secret police to diagnose dissidents as mentally ill and confine them to prisons that fronted as hospitals (Medvedev and Medvedev 1971).
This was a serious consideration. Indeed, we need not look beyond our own borders for examples of ethics violations committed by professionals who became entangled in politics. We have recently witnessed the disgrace of an entire professional organization, the American Psychological Association, some of whose leadership, in cooperation with officials from the U.S. military, the CIA, and the Bush White House, rewrote its ethical guidelines to give legal cover to a secret government program of coercive interrogation and to excuse military psychologists who designed and implemented methods of torture (Hoffman et al. 2015; Risen 2014).
Among the many lessons that might be learned from this notorious example, one in particular stayed with us. It seemed clear that the government officials responsible for abusive treatment of prisoners went to some lengths to find medical and mental health professionals who would publicly condone their practices. We reasoned that if professional endorsement serves as important cover for human rights abuses, then professional condemnation must also carry weight.
In 2005 the Pentagon organized a trip to the Guantánamo Bay detention camp for a group of prominent ethicists, psychiatrists, and psychologists. Participants toured the facility and met with high-ranking military officers, including the commanding general. They were not allowed to meet or speak with any of the detainees. Dr. Steven Sharfstein, then the president of the American Psychiatric Association, was one of the invited guests on this trip.
Apparently, what he saw and heard failed to convince him that the treatment of detainees fell within the bounds of ethical conduct. “Our position is very direct,” he stated on return. “Psychiatrists should not participate on these [interrogation] teams because it is inappropriate” (Lewis 2005). Under Dr. Sharfstein’s leadership, the American Psychiatric Association took a strong stand against any form of participation in torture and in the “interrogation of persons held in custody by military or civilian investigative or law enforcement authorities, whether in the United States or elsewhere” (American Psychiatric Association 2006).
Contrast this principled stand with the sorry tale of the American Psychological Association. Its involvement in the torture scandal illustrates how important it is for leaders in the professions to stand firm against ethical violations, and to resist succumbing to the argument that exceptional political circumstances, such as “the war on terror,” demand exceptions to basic ethical codes. When there is pressure from power is exactly when one must abide by the norms and rules of our ethics.
Norms and Rules in the Political Sphere
Norms and rules guide professional conduct, set standards, and point to the essential principles of practice. For these reasons, physicians have the Declaration of Geneva (World Medical Association 2006) and the American Medical Association Principles of Medical Ethics (2001), which guide the American Psychiatric Association’s code for psychiatry (American Psychiatric Association 2013).
The former confirms the physician’s dedication to the humanitarian goals of medicine, while the latter defines honorable behavior for the physician. Paramount in both is the health, safety, and survival of the patient. Psychiatrists’ codes of ethics derive directly from these principles. In ordinary practice, the patient’s right to confidentiality is the bedrock of mental health care dating back to the ethical standards of the Hippocratic Oath.
However, even this sacrosanct rule is not absolute. No doubt, the physician’s responsibility is first and foremost to the patient, but it extends “as well as to society” (American Psychiatric Association 2013, p. 2). It is part of professional expectation that the psychiatrist assess the possibility that the patient may harm himself or others. When the patient poses a danger, psychiatrists are not merely allowed but mandated to report, to incapacitate, and to take steps to protect.
If we are mindful of the dangers of politicizing the professions, then certainly we must heed the so-called “Goldwater rule,” or Section 7.3 of the APA code of ethics (American Psychiatric Association 2013, p. 6), which states: “it is unethical for a psychiatrist to offer a professional opinion [on a public figure] unless he or she has conducted an examination and has been granted proper authorization for such a statement.”
This is not divergent from ordinary norms of practice: the clinical approaches that we use to evaluate patients require a full examination. Formulating a credible diagnosis will always be limited when applied to public figures observed outside this intimate frame; in fact, we would go so far as to assert that it is impossible.
The Goldwater rule highlights the boundaries of practice, helps to preserve professional integrity, and protects public figures from defamation. It safeguards the public’s perception of the field of psychiatry as credible and trustworthy. It is reasonable to follow it. But even this respectable rule must be balanced against the other rules and principles of professional practice.
A careful ethical evaluation might ask: Do our ordinary norms of practice stop at the office of the president? If so, why? If the ethics of our practice stipulate that the health of our patient and the safety of the public be paramount, then we should not leave our norms at the door when entering the political sphere. Otherwise, a rule originally conceived to protect our profession from scandal might itself become a source of scandal.
For this very reason, the “reaffirmation” of the Goldwater rule in a separate statement by the American Psychiatric Association (2017) barely two months into the new administration seems questionable to us. The American Psychiatric Association is not immune to the kind of politically pressured acquiescence we have seen with its psychological counterpart. A psychiatrist who disregards the basic procedures of diagnosis and treatment and acts without discretion deserves reprimand. However, the public trust is also violated if the profession fails in its duty to alert the public when a person who holds the power of life and death over us all shows signs of clear, dangerous mental impairment.
We should pause if professionals are asked to remain silent when they have seen enough evidence to sound an alarm in every other situation. When it comes to dangerousness, should not the president of a democracy, as First Citizen, be subject to the same standards of practice as the rest of the citizenry?
Assessing dangerousness is different from making a diagnosis: it is dependent on the situation, not the person. Signs of likely dangerousness due to mental disorder can become apparent without a full diagnostic interview and can be detected from a distance, and one is expected to err, if at all, on the side of safety when the risk of inaction is too great.
States vary in their instructions. New York, for example, requires that two qualifying professionals agree in order to detain a person who may be in danger of hurting himself or others. Florida and the District of Columbia require only one professional’s opinion. Also, only one person need be in danger of harm by the individual, and the threshold is even lower if the individual has access to weapons (not to5 mention nuclear weapons).
The physician, to whom life-and-death situations are entrusted, is expected to know when it is appropriate to act, and to act responsibly when warranted. It is because of the weight of this responsibility that, rightfully, the physician should refrain from commenting on a public figure except in the rarest instance. Only in an emergency should a physician breach the trust of confidentiality and intervene without consent, and only in an emergency should a physician breach the Goldwater rule.
We believe that such an emergency now exists.
Test for Proper Responsibility
When we circulated our letters of concern, we asked our fellow mental health professionals to get involved in politics not only as citizens (a right most of us still enjoy) but also, specifically, as professionals and as guardians of the special knowledge with which they have been entrusted.
Why do we think this was permissible? It is all too easy to claim, as we did, that an emergency situation requires a departure from our usual practices in the private sphere. How can one judge whether political involvement is in fact justified? We would argue that the key question is whether mental health professionals are engaging in political collusion with state abuses of power or acting in resistance to them.
If we are asked to cooperate with state programs that violate human rights, then any involvement, regardless of the purported justification, can only corrupt, and the only appropriate ethical stance is to refuse participation of any sort.
If, on the other hand, we perceive that state power is being abused by an executive who seems to be mentally unstable, then we may certainly speak out, not only as citizens but also, we would argue, as professionals who are privy to special information and have a responsibility to educate the public. For whatever our wisdom and expertise may be worth, surely we are obligated to share it.
It doesn’t take a psychiatrist to notice that our president is mentally compromised. Members of the press have come up with their own diagnostic nomenclature, calling the president a “mad king” (Dowd 2017), a “nut job” (Collins 2017), and “emotionally unhinged” (Rubin 2017). Conservative columnist George Will (2017) writes that the president has a “disorderly mind.”
By speaking out as mental health professionals, we lend support and dignity to our fellow citizens who are justifiably alarmed by the president’s furious tirades, conspiracy fantasies, aversion to facts, and attraction to violence. We can offer a hand in helping the public understand behaviors that are unusual and alarming but that can all too easily be rationalized and normalized.
An important and relevant question that the public has been asking is this: Is the man simply crazy, or is he crazy like a fox? Is he mentally compromised or simply vile? When he lies, does he know he is lying, or does he believe his own lies? When he makes wild accusations, is he truly paranoid, or is he consciously and cunningly trying to deflect attention from his misdeeds?
We believe that we can help answer these questions by emphasizing that the two propositions are not mutually exclusive. A man can be both evil and mentally compromised—which is a more frightening proposition.
Power not only corrupts but also magnifies existing psychopathologies, even as it creates new ones. Fostered by the flattery of underlings and the chants of crowds, a political leader’s grandiosity may morph into grotesque delusions of grandeur. Sociopathic traits may be amplified as the leader discovers that he can violate the norms of civil society and even commit crimes with impunity. And the leader who rules through fear, lies, and betrayal may become increasingly isolated and paranoid, as the loyalty of even his closest confidants must forever be suspect.
Some would argue that by paying attention to the president’s mental state, we are colluding with him in deflecting attention from that by which he should ultimately be judged: his actions (Frances 2017). Certainly, mental disturbance is not an excuse for tyrannical behavior; nevertheless, it cannot be ignored. In a court of law, even the strongest insanity defense case cannot show that a person is insane all the time.
We submit that by paying attention to the president’s mental state as well as his actions, we are better informed to assess his dangerousness. Delusional levels of grandiosity, impulsivity, and the compulsions of mental impairment, when combined with an authoritarian cult of personality and contempt for the rule of law, are a toxic mix.
There are those who still hold out hope that this president can be prevailed upon to listen to reason and curb his erratic behavior. Our professional experience would suggest otherwise; witness the numerous submissions we have received for this volume while organizing a Yale conference in April 2017 entitled “Does Professional Responsibility Include a Duty to Warn?”
Collectively with our coauthors, we warn that anyone as mentally unstable as Mr. Trump simply should not be entrusted with the life-and-death powers of the presidency.
Our Duty to Warn
BANDY X. LEE, M.D., M.DIV.
Possibly the oddest experience in my career as a psychiatrist has been to find that the only people not allowed to speak about an issue are those who know the most about it. Hence, truth is suppressed. Yet, what if that truth, furthermore, harbored dangers of such magnitude that it could be the key to future human survival? How can I, as a medical and mental health professional, remain a bystander in the face of one of the greatest emergencies of our time, when I have been called to step in everywhere else?
How can we, as trained professionals in this very area, be content to keep silent, against every other principle we practice by, because of a decree handed down from above? I am not speaking of the long-standing “Goldwater rule,” which is discussed in many places throughout this book and is a norm of ordinary practice I happen to agree with. I am rather speaking of its radical expansion, beyond the status we confer to any other rule, barely two months into the very presidency that has made it controversial.
This occurred on March 16, 2017, when our professional organization essentially placed a gag order on all psychiatrists (American Psychiatric Association 2017), and by extension all mental health professionals. I am also speaking of its defect, whereby it does not have a countervailing rule, as does the rest of professional ethics, that directs what to do when the risk of harm from remaining silent outweighs the damage that could result from speaking about a public figure—which, in this case, could even be the greatest possible harm.
Authors in this volume have been asked to respect the Goldwater rule and not to breach it unnecessarily, but I in turn respect their choices wherever their conscience has prompted them to take the professionally and socially radical step to help protect the public. Therefore, it would be accurate to state that, while we respect the rule, we deem it subordinate to the single most important principle that guides our professional conduct: that we hold our responsibility to human life and well-being as paramount.
My reasons for compiling this compendium are the same as my reasons for organizing the Yale conference by the title, “Does Professional Responsibility Include a Duty to Warn?”: the issue merits discussion, not silence, and the public deserves education, not further darkness.
Over the course of preparing the conference, the number of prominent voices in the field coming forth to speak out on the topic astonished me. Soon after the 2016 presidential election, Dr. Herman (coauthor of the Prologue), an old colleague and friend, had written a letter urging President Obama to require that Mr. Trump undergo a neuropsychiatric evaluation before assuming the office of the presidency. Her cosignatories, Drs. Gartrell and Mosbacher (authors of the essay “He’s Got the World in His Hands and His Finger on the Trigger”), helped the letter’s publication in The Huffington Post (Greene, 2016).
I also reached out to Dr. Lifton (author of the Foreword), whose “Mass Violence” meetings at Harvard first acquainted me with Dr. Herman years ago; together, they had sent a letter to the New York Times (Herman and Lifton 2017). His ready consent to speak at my conference sparked all that was to follow.
I encountered others along the way: Dr. Dodes (author of “Sociopathy”), who published a letter in the New York Times with thirty-five signatures (Dodes and Schachter 2017); Ms. Jhueck (author of “A Clinical Case for the Dangerousness of Donald J. Trump”), who cowrote and posted a letter to the head of New York City’s Department of Health and Mental Hygiene with seventy signatures; Dr. Fisher (author of “The Loneliness of Fateful Decisions”), who also expressed concerns in a letter to the New York Times (Fisher 2017); and Dr. Gartner (author of “Donald Trump Is: [A] Bad, [B] Mad, [C] All of the Above”), the initiator of an online petition, now with fifty-five thousand signatures, who cofounded the national coalition, “Duty to Warn,” of (as of this writing) seventeen hundred mental health professionals.
The Yale Conference
On April 20, 2017, Dr. Charles Dike of my division at Yale started the town hall–style meeting by reaffirming the relevance and reasons for the Goldwater rule. As assistant professor in law and psychiatry, former chair of the Ethics Committee of the American Academy of Psychiatry and the Law, chair of the Connecticut Psychiatric Society Ethics Committee, member of the Ethics Committee of the American Psychiatric Association, and Distinguished Fellow of the American Psychiatric Association, he was more than qualified to do so.
It was important that we start with a firm ethical foundation: whatever our conclusion, it could not hold if we were not scrupulous about our ethical grounding. I invited as additional panelists Drs. Lifton, Herman, and Gilligan (the last the author of “The Issue Is Dangerousness, Not Mental Illness”), with the purpose of bringing together the finest minds of psychiatry I could to address the quandary. They are all colleagues I have known for at least fifteen years and highly esteem not only for their eminence in the field but also for their ethics. They were beacons during other dark times.
They abided by the Goldwater rule in that they kept the discussion at the level of dangerousness, without attempting to diagnose. The transcript of the meeting can be found in an online appendix, the link to which is at the end of this book.
The conference was initially meant to be a collaboration between Yale School of Medicine, Yale School of Public Health, and Yale School of Nursing, but when the other schools fell away as the date approached, I released the School of Medicine for what I correctly perceived would be “inevitable politicization.” In case something went wrong, I did not wish to imperil my alma mater and home institution.
Our nation is now living, in extremes, a paradigm that splits along partisan lines, and the quick conclusion will be that the speakers or contributors of this volume “must be Democrats” if they are casting a negative light on a Republican president.
However, there are other paradigms. For the mental health professional, the paradigm we practice by is one of health versus disease. We appeal to science, research, observed phenomena, and clinical skill developed over years of practice in order to promote life and to prevent death. These goals cannot be contained within the purposes of a political party or the campaigns of a candidate. Rather, we are constantly trained to bring medical neutrality—or, if we cannot, to recuse ourselves of the therapeutic situation. It is a glimpse of this perspective that we hope to bring to the reader.
Our meeting gained national and international attention (Milligan 2017; Bulman 2017). While only two dozen physically attended the conference in an atmosphere of fear, about a hundred tuned in online, and hundreds more got in touch with me for recordings or in a show of support. It felt as if we had tapped into a groundswell of a movement among mental health professionals, and also an army of people who wanted to speak about the issue (DeVega 2017).
What was intended as a publication of the proceedings led to this volume (initially so large that we had to reduce it by a third), and five top-tier publishers in the country vied for it.
Authors had to submit their manuscripts within three weeks of the meeting. It was a harrowing time, as the nation’s mood changed from relief as Mr. Trump seemed to settle into his office after the first one hundred days, to a new onslaught of scandals, starting with his firing of FBI director James Comey on May 9, 2017.
Many of the contributors here do not need an introduction, and I am humbled to have the opportunity to present such an assembly of brilliant and principled professionals. A Compendium of Expertise This volume consists of three parts, the first being devoted to describing Mr. Trump, with an understanding that no definitive diagnoses will be possible.
In “Unbridled and Extreme Present Hedonism,” Zimbardo and Sword discuss how the Leader of the Free World has proven himself unfit for duty by his extreme ties to the present moment, without much thought for the consequences of his actions or for the future.
In “Pathological Narcissism and Politics,” Malkin explains that narcissism happens on a scale, and that pathological levels in a leader can spiral into psychosis and imperil the safety of his country through paranoia, impaired judgment, volatile decision making, and behavior called gaslighting.
In “I Wrote The Art of the Deal with Trump,” Schwartz reveals how what he observed during the year he spent with Trump to write that book could have predicted his presidency of “black hole-level” low self-worth, fact-free self-justification, and a compulsion to go to war with the world.
In “Trump’s Trust Deficit Is the Core Problem,” Sheehy highlights the notion that beneath the grandiose behavior of every narcissist lies the pit of fragile self-esteem; more than anything, Trump lacks trust in himself, which may lead him to take drastic actions to prove himself to himself and to the world.
In “Sociopathy,” Dodes shows that someone who cons others, lies, cheats, and manipulates to get what he wants, and who doesn’t care whom he hurts, may be not just repetitively immoral but also severely impaired, as sociopaths lack a central human characteristic, empathy.
In “Donald Trump Is: (A) Bad, (B), Mad, (C) All of the Above,” Gartner emphasizes the complexity of Trump’s presentation, in that he shows signs of being “bad” as well as “mad,” but also with a hypomanic temperament that generates whirlwinds of activity and a constant need for stimulation.
In “Why ‘Crazy Like a Fox’ versus ‘Crazy Like a Crazy’ Really Matters,” Tansey shows that Trump’s nearly outrageous lies may be explained by delusional disorder, about which Tansey invites the reader to make the call; even more frightening are Trump’s attraction to brutal tyrants and also the prospect of nuclear war.
In “Cognitive Impairment, Dementia, and POTUS,” Reiss writes that a current vulnerability in our political system is that it sets no intellectual or cognitive standards for being president, despite the job’s inherently requiring cognitive clarity; this lack of clarity can be even more serious if combined with other psychiatric disorders.
In “Donald J. Trump, Alleged Incapacitated Person,” Herb explains how, as a guardianship attorney (in contrast to a mental health professional), he is required to come to a preliminary conclusion about mental incapacity before filing a petition, which he does in his essay, while reflecting on the Electoral College and the Twenty-Fifth Amendment to the U.S. Constitution.
The second part of the book addresses the dilemmas that mental health professionals face in observing what they do and speaking out when they feel they must.
In “Should Psychiatrists Refrain from Commenting on Trump’s Psychology?” Glass argues against a technicality that would yield a simple yes-or-no answer to the Goldwater rule; instead, he advocates for a conscientious voicing of hazardous patterns, noting that the presence of mental illness is not as relevant as that of reliable functionality.
In “On Seeing What You See and Saying What You Know,” Friedman notes that technological advances that allow assessment and treatment from a distance, especially in underserved areas, have changed the clinician’s comfort level with remote evaluations, even when detecting a totalitarian mind-set or a multidimensional threat to the world.
In “The Issue Is Dangerousness, Not Mental Illness,” Gilligan discusses the ethics of not diagnosing a public figure versus the duty to warn potential victims of danger; when invoking the latter, he emphasizes, what matters is not whether a person is mentally ill but whether he is dangerous, which is possible to assess from a distance.
In “A Clinical Case for the Dangerousness of Donald J. Trump,” Jhueck notes that the United States legally confers mental health professionals and physicians considerable power to detain people against their will if they pose a danger due to likely mental illness—and Trump more than meets the requisite criteria.
In “Health, Risk, and the Duty to Protect the Community,” Covitz offers an ancient reference and two fables to illustrate just how unusual the mental health profession’s response is to a dangerous president, as we do not to speak up in ways that would be unthinkable for our role with other members of society.
In “New Opportunities for Therapy in the Age of Trump,” Doherty claims that the Trump era has ruptured the boundary between the personal and the public, and while clients and therapists are equally distressed, integrating our roles as therapists and citizens might help us better help clients.
The book’s third part speaks to the societal effects Mr. Trump has had, represents, and could cause in the future.
In “Trauma, Time, Truth, and Trump,” Teng points out the irony of seeing, as a trauma therapist, all the signs of traumatization and retraumatization from a peaceful election; she traces the sources of the president’s sudden military actions, his generation of crises, his shaken notions of truth and facts, and his role in reminding patients of an aggressive abuser.
In “Trump Anxiety Disorder,” Panning describes a unique post-election anxiety syndrome that has emerged as a result of the Trump presidency and the task that many therapists face with helping clients manage the stress of trying to “normalize” behavior that they do not feel is normal for a president.
In her essay “In Relationship with an Abusive President,” West illustrates the dynamics of “other blaming” in individuals who have feelings of low self-worth and hence poor shame tolerance, which lead to vindictive anger, lack of accountability, dishonesty, lack of empathy, and attention-seeking, of which Trump is an extreme example.
In “Trump’s Daddy Issues,” Wruble draws on his own personal experiences, especially his relationship with his strong and successful father, to demonstrate what a therapist does routinely: uses self-knowledge as an instrument for evaluating and “knowing” the other, even in this case, where the other is the president and his followers.
In “Birtherism and the Deployment of the Trumpian Mind-Set,” Kessler portrays the broader background from which “birtherism” began and how, by entering into the political fray by championing this fringe sentiment, Trump amplifies and exacerbates a national “symptom” of bigotry and division in ways that are dangerous to the nation’s core principles.
In “Trump and the American Collective Psyche,” Singer draws a connection between Trump’s personal narcissism and the American group psyche, not through a political analysis but through group psychology—the joining of group self-identity with violent, hateful defenses is as much about us as about Trump.
In “Who Goes Trump?” Mika explains how tyrannies are “toxic triangles,” as political scientists call them, necessitating that the tyrant, his supporters, and the society at large bind around narcissism; while the three factors animate for a while, the characteristic oppression, dehumanization, and violence inevitably bring on downfall.
In “The Loneliness of Fateful Decisions,” Fisher recounts the Cuban Missile Crisis and notes how, even though President Kennedy surrounded himself with the “best and the brightest,” they disagreed greatly, leaving him alone to make the decisions—which illustrates how the future of our country and the world hang on a president’s mental clarity.
In “He’s Got the World in His Hands and His Finger on the Trigger,” Gartrell and Mosbacher note how, while military personnel must undergo rigorous evaluations to assess their mental and medical fitness for duty, there is no such requirement for their commander in chief; they propose a nonpartisan panel of neuropsychiatrists for annual screening.
In spite of its title, I would like to emphasize that the main point of this book is not about Mr. Trump. It is about the larger context that has given rise to his presidency, and the greater population that he affects by virtue of his position.
The ascendancy of an individual with such impairments speaks to our general state of health and well-being as a nation, and to how we can respond: we can either improve it or further impair it.
Mental disorder does not distinguish between political parties, and as professionals devoted to promoting mental health, including public mental health, our duty should be clear: to steer patients and the public on a path toward health so that genuine discussions of political choice, unimpeded by emotional compulsion or defense, can occur.
Embracing our “duty to warn,” as our professional training and ethics lead us to do at times of danger, therefore involves not only sounding an alarm but continually educating and engaging in dialogue our fellow human beings, as this compilation aspires to do.
get it at Amazon.com
This is what I was imagining on October 7, 2016, when Hurricane Matthew was building in the Caribbean. The forecast was predicting a direct hit on Guantánamo, so the camp command decided to move all the detainees, about seventy of us, to Camp 6, the safest facility in GTMO. I was told that my belongings might not survive the hurricane, so I took my family pictures, my Koran, and two DVDs of the TV sitcom Two and a Half Men. The NCO in charge, a sympathetic Hispanic sergeant first class in his forties, arranged for another detainee to lend me his portable DVD player, but the machine died within minutes.
Outside my cell, an argument broke out between one of the detainees and the guards over the temperature in the block, an argument we all knew was futile, but the detainee had started and now couldn’t stop. “You Americans, even if I treat you as human beings, you don’t respect me,” he was yelling. “We can do this the easy way or the hard way,” the guards were yelling back.
I did my best to tune them out, and I spent the night listening for the sound of the heavy wind battering the cell, daydreaming another dramatic escape. The structure was so strong that I never even heard the storm.
But in the morning the camp was buzzing with rumors about detainees who were going to leave. One rumor said that there was a comprehensive plan that I was going be resettled along with Abdul Latif Nasir, a Moroccan detainee, and Soufiane Barhoumi from Algeria. We had all heard so many rumors over the years that turned out to be just that, rumors, that we knew not to celebrate; this would prove to be another.
For me, though, the real news came that afternoon. The bearer was our brand-new officer in charge. She had just taken over and I had not even met her yet, but now this army captain was sticking her head through my bin hole and giving me the broadest smile I’d seen in many years. “Do you know that you’re going to leave soon?” she said.
It was the best introduction to a new OIC ever: I’m taking over, and you’re going home. I was moved to a different cellblock. I met with representatives from the International Committee of the Red Cross, who officially informed me that I was to be transferred.
The U.S. government dreads the mention of detainees being freed, so it uses its own vocabulary of “transfer” and “resettlement,” as if we were cargo or refugees. Yazan, a Jordanian representative I knew from previous ICRC delegations, asked if I would accept resettlement to my home country of Mauritania. I told him I would take any transfer I was offered, quoting the title of a Chris Cagle country song: “Anywhere but Here.”
The next day, my attorneys Nancy Hollander and Theresa Duncan called me from the United States to confirm the news. Only then I could say to myself, Now it’s official: I’m leaving this prison after so many years of pain and humiliation.
“You have the Gold Meeting tomorrow,” the new OIC told me when I got back to my cell after the call. Her smile still hadn’t faded. The “Gold Meeting” takes place in Gold Building, a structure that was built for interrogation. At first, the interrogations there were not so bad by Guantánamo standards. We answered all kinds of questions from FBI, CIA, and military intelligence officers, as well as investigators who came from around the world at the invitation of their American colleagues. But the building was given a face-lift in 2003 and then was used along with the so-called Brown and Yellow buildings for torture sessions. It was in this same Gold Building that I spent many sleepless and cold nights that year, shivering in my shackles, eating countless tasteless MREs, and listening to “Oh say can you see, by the dawn’s early light” in an endless, repeating loop.
Now the bushes around the building were growing out of control, and the old Delta Three camp next door looked like a graveyard. Romeo block, where I spent my last days before I was dragged into a boat in a fake kidnapping, existed only in bits and pieces. Everything was old and rusted and dirty. It looked like a scene after one of my hurricane daydreams.
Inside Gold Building, though, nothing had changed. Its rooms were now assigned for FBI and Army Forensics, for phone calls to lawyers, and for meetings with the ICRC. But they were still set up the same way, with their one-way mirrors and the adjacent control rooms where a bunch of idle Joint Task Force (JTF) personnel would sit chewing on their cold cheese-burgers, watching me, and asking themselves how I’d ended up in this place. Even the smell was the same: at the first hint of it, I was hearing the sound my heavy chains made the day I was dragged down the corridor to a room where I would meet Sergeant Mary, one of the main interrogators on my so-called Special Projects team.
One night in August 2003, I sat shackled in one of those rooms listening to a phone conversation one of my interpreters was having. She was calling her family back in the United States, and she had forgotten to close the door behind her. English seemed like her first language, but she was speaking to her family in Arabic, with a soft Lebanese or Syrian accent. To hear her casually sharing mundane stories about life in GTMO, very relaxed, completely oblivious to the man suffering next to her, was surreal, but it was just what I needed on that cold, unfriendly evening. I wished her soothing, musical conversation wouldn’t end: she was my surrogate, doing for me what I couldn’t do for myself. I saw in her a physical and spiritual conduit to my own family, and I told myself that if her family was doing well, my family must be doing well, too.
That I was mitigating my loneliness by listening to someone else’s intimate, personal conversation posed a moral dilemma for me: I needed to survive, but I also wanted to keep my dignity and respect the dignity of others. To this day I am sorry for eavesdropping, and I can only hope she would forgive my unintentional transgression.
Now, for the “Gold Meeting,” my interpreter was a small brown Arab-American in his early thirties, with short, receding black hair. “Are you from West Africa?” he asked in Arabic as I was led into a room and shackled to the floor. My ankle chains provided a musical backdrop to our conversation, echoing throughout Gold Building.
What do other people think about us being shackled? I always wondered in these situations. Do they find it normal to interact with a restrained human being? Do they feel bad for us? Do they feel safer?
“Yes, Mauritania,” I answered in Arabic, smiling. “Do you understand when I speak?” The room was packed with people I didn’t know, mostly high-ranking military officers, and he seemed eager to show how essential he was to the proceedings. My escort team pushed the desk close enough that I could lean on it and hide my shackled feet underneath, giving the impression of a relaxed, free man. A recent picture of me adorned the door.
We waited. Like everywhere on earth, the big boss did not need to show up on time. Finally the voice of a service member, shouting as if an assault was under way, roused the room to its feet. “Colonel Gabavics, JDG Commander, on site.” The door opened and there he stood, in the flesh. It was the first and last time this man would speak to me. “You will be transferred to your country in one week. Do you have any questions?”
Because I could hardly imagine life outside Guantánamo after so many years of incarceration, I had no idea what questions to ask. I made a request instead. I told the colonel that I wished to bring my manuscripts with me—I wrote four in addition to Guantánamo Diary during my imprisonment—and some other writing and paintings I had made in classes I took in GTMO. I said I would also like to take several chessboards, books, and other presents I had received from his predecessors and from some of my guards and interrogators, gifts that had great sentimental value. I named those who had given me these presents, hoping he would honor my request for the sake of his friends. “I’ll talk to the people in charge,” he said. “If it’s okay, we will send them with you.”
I thanked him, smiling, wanting the meeting to end on that good note and not to screw things up by saying things I wasn’t supposed to say. The colonel disappeared as quickly as he came. The escort team took me to the room across the hall, where I found two women in uniform. A skinny brunette Army sergeant sat in front of an old Dell desktop that was running Windows 7. She kept smiling, even though her computer was a classic recipe for frustration; she typed everything at least twice, and the PC kept passing out on her.
On her right sat a woman who seemed to be her boss, at least by rank, a short blond Navy lieutenant with a neat ponytail. She was friendly, too, and even asked my escort team to remove all my shackles. There followed a photo shoot that had me posing five different ways: face the camera, face right, face left, and forty-five degrees to both sides. I had to give my fingerprints in about a dozen ways on an electronic pad. They recorded my voice as I read a page written in English: “My name is fill in the blank. I’m from fill in the blank. I love my country,” and the like. That was as literary as it got. I must have been nervous, because I passed this voice recognition test only on the second try.
Through it all, the sergeant struggled to save my biometric data into the old computer. My escorts restrained me again and took me to another room, this one with an FBI team. “If you promise to behave, I’ll let them take off your restraints,” a Turkish-American agent said with an honest smile. The FBI team fingerprinted me, using the old method of sticking my fingers in ink and pressing them on a paper. It was a long, tedious process, which gave me time to try out my Turkish with the agent. As we talked, his finger slipped and made its own print on the paper. He freaked out, grabbed a fresh paper, and we started again. “I hope this will be the last time you ever have to do this,” he said, laughing and handing me some sandy soap to clean my fingers.
There were four other standard-issue FBI agents in the room, two middle-aged women and two other men. The whole team was having a good time with me. “You don’t need to hope,” I assured him. “You can bet your last penny.” I was taken to my new home, the transfer camp. I had seen this camp a million times: it was right next to the Camp Echo isolation hut, where I lived for twelve years. If I believed in conspiracy theories, I would have said that the government purposely put the transfer camp right next to my cell for all those years to make me suffer even more. So many detainees were transferred out during those years, and I would be the last one to bid them farewell. We would speak to each other through the fence that separates the two camps. It was comforting to see innocent men finally being freed, and I was happy for every detainee who passed through the transfer camp, but it stung to watch them leave.
Now that detainee was me, and I couldn’t help but feel guilty. It hurt to think of leaving other innocent detainees behind, their fates in the hand of a system that has failed so badly in matters of justice. “We missed you, 760,” one of my old regular Camp Echo guards greeted me as I was unstrapped from the seat of the transport van.
As we walked through the camp, a small, blond female sergeant with a southern accent went over the new rules. “You can go anywhere you like in the camp, but you’re not supposed to cross that red line. Honestly, I don’t care if you do, but don’t hang out long, because if they see you on the camera, we could get in trouble,” she told me as she led me to my new home. “We push the food cart all the way to the white line,” she went on, going over procedures I would be hearing for the last time. In one of the strange tricks of Guantánamo, the sergeant and I walked and conversed like old friends, completely overlooking the fact that I was shackled.
Because of the hurricane, many of the mesh sniper screens on the windows had been removed from the Camp Echo huts, and the contractors—mostly so-called Third Country Nationals, who make very low wages and struggle to maintain the facilities—had not finished putting them back up. From my cell, I saw a whole world that had been surrounding me for many years, so close but so elusive: the maze of interrogation rooms; Camp Legal, where detainees meet their lawyers; the hut where the translators and teachers watched TV, waiting for their next encounter with detainees; and the two buildings where detainees come to call and Skype with their families. In a parking lot nearby, people parked their big American vans and climbed out of them, looking bored and sick of their tedious jobs.
Through the fence that separates my old Camp Echo Special hut from the transfer camp, I could see that my garden was gone, except for the untended grass and the few trees whose resilience is matched by those of us detainees who had managed to remain in one piece.
For the next several days, JTF staff kept pouring in to brief me about what was happening with my transfer. The news was coming thick and fast, from guards, from the OIC, the NCO in charge, from an officer from the Behavior Health Unit, and from the senior medical officer.
Everyone brought good news. I was told that my items were packed and had been sent to the transport people and that they would be loaded onto the plane with me. An Air Force captain from the BHU said that she had been planning to see me the following Monday, but she now doubted I would still be here. The senior medical officer, a Navy captain, came in person to hand me malaria medication, a sure sign that my departure was imminent.
In between these visits, I spent most of my time talking with the guards about what kinds of electronic gadgets I would need to acquire when I got out, and the best ways to watch all the movies I had been forbidden to watch in GTMO. They taught me about streaming sites like Netflix and Putlocker, and even about illegal downloading.
And then the day came: Sunday, October 16, 2016. All day, people in uniform kept coming and going, most saying little, if anything at all. It was surreal—as if the whole base now had only one detainee to worry about. My new favorite OIC showed up again and again with her broad smile. My night shift didn’t show up at all. “Where’s the other shift?” I asked one of the guards, a guy who had been tutoring me on how to deal with the new technologies that were waiting to overwhelm me.
“I would love it if they let me be the one leading you out of here, and the last one to say goodbye to you,” he said. The specialist’s prayer was answered; he would put the shackles on me for the last time. He grew less talkative as the afternoon wore on. Everyone seemed solemn, and a complete and utter silence descended when the smiling captain came to me and said, “You have two hours left. We’re going to lock you down.”
“Now it’s for real,” I told myself. I went inside the cell and heard one of my guards trying to lock the door manually, a very familiar sound. Whenever civilians like teachers or contractors would come from outside the camp, we would be locked like this inside our cells. I took a shower and shaved. I dressed in the new detainee uniform I had been given. My old clothes, like all my belongings in the cell, had to be left behind.
I tried to watch TV, then read a book, but I could do neither. I just kept pacing inside my room, praying and singing quietly. It was the longest two hours of my entire life. “Are you ready?” the captain finally said as she looked through my bin hole. “Yes.” “Can you stick your hands outside the bin hole?” one of the guards asked. I offered my hands, and the guards put the shackles on my wrists, gently yet firmly, asking whether the cuffs were too tight. I shook my head. After my hands were restrained, the guards opened the door to finish my upper body and my legs.
I was shocked to see how many people could fit in that small place. I saw people in uniform everywhere I looked, including the overeager translator from my meeting with the colonel. But this time he watched and said nothing. The only place I’d ever seen such solemnity was when I attended funerals. I hardly spoke, just nodding when someone asked a question. The female captain was guiding the guards, telling them what to do next. “Take him to the red line.” The red line was about sixty steps away from my door. I felt as though I could hear people’s hearts beating as clearly as the Black Eyed Peas’ “Boom Boom Pow.”
My escort team seemed nervous, and they went too far. The captain had to shout at them, “Do not cross the red line. Step back. Step back.” The guards obeyed, leading me backward and stopping just in front of the line. A huge gate opened, and a new escort team emerged. They quietly took control of me from my guards. They did not do the usual inspection of my restraints; they did not say anything as they led me outside the gate.
Another group was gathered there, including the senior medical officer and a very tall white man in uniform who was wearing a backpack and whose rank I couldn’t see. It was dark outside, but I could see that he was holding a printout with a recent picture of me. He placed the picture beside my face, looked back and forth, and shouted, “Identity confirmed.” The whole team looked as if they’d just arrived from a long trip. They all seemed sleepy, even the small black woman who’d been pointing her video camera at me from the moment I left my cell. A skinny blondish specialist would join her in the bus that transported us to the airport, and they would take turns on the camera all the way to Nouakchott.
“Do you have any complaints?” the senior medical officer asked. I shook my head. “No.” A slight smile broke across his face, and he almost shouted,
“760, I declare you fit to fly.”
We passed through two more gates. We boarded a bus that drove onto a ferry, and the bus danced like a dervish in a trance as the ferry crossed the bay. We pulled out onto the airstrip and up to the back door of a cargo plane big enough to drive a truck inside. The engines were roaring, and everyone had to shout to convey the simplest message. I was led up a long cargo ramp. As soon as we stepped inside the plane I was earmuffed and blindfolded, just as I had been when I was taken from Bagram Air Base to Guantánamo Bay. This time, though, there was no beating, harassment, or degradation.
I was strapped into a hard seat that was set nearly at a right angle and that did not recline. I didn’t dare to complain for fear someone would change his mind and take me back to the camp. I lost track of time during the flight, fighting against the pain that began in my back, spread to my ears and head, and soon overwhelmed me from all directions.
The plane landed with a heavy thump, and I felt someone peeling off my blindfold and my earmuffs. The first thing I saw was a digital clock on the wall of the plane in front of me—a little past 14:00, it read—and a bunch of half-asleep recruits who looked like they had not had their best night. I felt gentle hands playing with my shackles, starting from the middle and working up and down. “Did we arrive? I asked tentatively, barely in a whisper. “Yes,” a guard beside me said. “Is this the local time?” “Yes.”
There was no mistaking the Mauritanian weather. It was a good day, not too hot—just the right, warm welcome I needed. I was escorted, unshackled, down the ramp and onto the tarmac, where several Mauritanian government officials and an American official waited. We exchanged casual greetings, and my U.S. service member escorts went directly to stand in formation near their countryman.
After a few pleasantries, the American started toward his car. “Who’s that?” I asked one of the Mauritanians. “The U.S. ambassador,” he said. “Can I say hello to him?” I asked.
He dispatched a man standing near him. The ambassador came back to me and we shook hands. “Welcome home,” he said.
from GUANTÁNAMO DIARY
by Mohamedou Ould Slahi
get it at Amazon.com
Author and academic Nancy MacLean says cynicism about the motives of public servants, including government-backed climate scientists, can be traced to a group of neoliberals and their ‘toxic’ ideas.
You’ll have heard that line of argument about cancer scientists, right?
The one where they’re just in it for the government grant money and that they don’t really want to find a cure, because if they did they’d be out of a job?
No, of course you haven’t. That’s because it’s ridiculous and a bit, well, vomit-inducing.
To make such an argument, you would need to be deeply cynical about people’s motives for consistently putting their own pay packets above the welfare of millions of people.
You would have to think that scientists were not motivated to help their fellow human beings, but instead were driven only by self-interest.
Suggesting that climate scientists are pushing a line about global warming because their salaries depend on it is a popular talking point that deniers love to throw around.
But why do so many “sceptics”, particularly those who form part of the organised machinery of climate science denial, feel comfortable in accusing climate scientists of only being in it for the money?
Duke University history professor Nancy MacLean suggests some answers in her new book Democracy in Chains: the Deep History of the Radical Right’s Stealth Plan for America.
The book documents how wealthy conservatives, in particular petrochemical billionaire Charles Koch, teamed up with neoliberal academics with the objective, MacLean says, of undermining the functions of government in the United States.
MacLean’s central character is the late James McGill Buchanan, a political theorist and economist who won a Nobel award in 1986 for his development of “public choice theory”.
Buchanan and Koch developed and propagated their ideas through a private organisation called the Mont Pelerin Society (MPS) – an influential group known as the “neoliberal thought collective” that was established in 1947 by famed free market economist Friedrich Hayek. Buchanan was a former president and joined in 1957. Koch, who has poured millions into groups attacking mainstream climate science, joined MPS in 1970. MPS has about 500 members in more than 40 countries.
In the US it has many members who also work at think tanks that push climate science misinformation and attack renewable energy. A membership list from 2013 showed Australian members included the Institute of Public Affairs boss John Roskam, former prime minister John Howard business figure Maurice Newman and former senator Bob Day.
MacLean argues that in the minds of many exponents of this “public choice” school, people are motivated primarily by self-interest.
Public choice advocates will argue that people who work in government will push for increased departmental budgets primarily to protect their job prospects.
In an interview at the Brisbane writers festival, MacLean told me: “If you read some of the stuff that comes out of the people in the ‘public choice’ school, they will say that these climate scientists are just after the next federal grant … they will try and discredit them as human beings. It’s really toxic stuff.”
When Buchanan received his Nobel award, Prof Steven Kelman, at Harvard’s John F. Kennedy school of government, wrote that Buchanan’s view was a “terrible caricature of reality ” and belied the public spirit of elected representatives and government officials.
This brings us back to the notion that cancer doctors might have a personal interest in not finding a cure. Proponents of public choice – including those who worked with Buchanan – have made just those claims.
In 1992, two academics from the Center for the Study of Public Choice at George Mason University (a centre established and led by Buchanan), wrote a book called The Economics of Smoking. In the book, economist Robert Tollison argued that the “anti-cancer bureaucracy will face weaker incentives to find and develop effective treatments of and cures for cancer, as well as facing incentives to magnify the risks of cancer”.
“A cure for cancer would put many cancer bureaucrats out of work,” Tollison wrote.
So the argument goes that these anti-cancer “bureaucrats” were not so much motivated to protect people from painful and deadly conditions linked to smoking, such as cancer and heart disease. Instead, they might work a bit less stringently to find a cure in return for a wage.
There’s an irony in this accusation of people acting in their self-interest. Before and after writing that book chapter, Tollison was paid consultancy fees by the tobacco industry.
In the archives of tobacco documents released as part of US litigation, you can find a 1988 invoice sent to the Tobacco Institute for Tollison work on a “media tour”.
In 1993, the archives reveal, Tollison and his GMU colleague Robert Wagner, who co-wrote The Economics of Smoking, pitched to the tobacco industry a report attacking the World Health Organization, which would cost $20,000.
Again, the pair would accuse “WHO bureaucrats” of engaging in spending patterns that “reflect the interests of bureaucrats”. The WHO should not be spending money on programs “against cigarettes”, the pair wrote.
MacLean points to a Bloomberg column by the liberal economist and Buchanan acolyte Amity Schlaes, written after Buchanan’s death.
Schlaes wrote glowingly that Buchanan’s “public-choice theory explained everything” to her about the true motives of public officials.
“Health officials’ interests in testing small children’s blood for lead made sense when one considered that finding poisoned children validated their jobs,” wrote Schlaes, who became a member of the Mont Pelerin Society in 2008.
“This is how someone could think,” MacLean tells me. “That a doctor would not be concerned about preventing a child from getting lifelong brain damage … no … they just wanted to expand their checking accounts. It’s really toxic.
“You’ve created this toxic wasteland now, and you can see the damage that those ideas have done,” she says.
It would be hopelessly naive to argue that money never motivates people to do certain things.
But to suggest global warming exists only because climate scientists need the money, you need to ignore melting ice sheets, rising sea levels, increasing extreme weather events, strings of record hot years, retreating glaciers, acidifying oceans, warming sea temperatures and bleaching corals. Or claim there is a conspiracy to manufacture these impacts in exchange for a wage.
Democracy In Chains Introduction
THE DEEP HISTORY OF THE RADICAL RIGHT’S STEALTH PLAN FOR AMERICA
I watched my president perforate at the Pentagon and all I could think as he held forth about heroism on the 16th anniversary of 9/11 was how did we end up with Humpty Dumpty.
It was Humpty Dumpty, of course, who declared: “When I use a word, it means just what I choose it to mean — neither more nor less.” At least Humpty Dumpty said it without that repetitive thumb-to-stubby-forefinger gesture of our esteemed leader.
Words cascade from that pinched mouth and they mean nothing, because when a man of moral emptiness tries to exhort a nation to moral greatness the only thing communicated is pitiful, almost comical, hypocrisy.
Between a hero and a huckster, between speaking and mouthing, the distance is great. Watching the esteemed leader’s head turning jerkily, like an old electric fan, from teleprompter to teleprompter, I almost felt pity. His is the Age of Indecency
President Trump seems lonely in his evident unfitness. Between him and his wife Melania I imagine what John Lanchester once described as “one of those silences which can only be incubated by at least two decades of attritional intimacy.” Well, they’ve known each other for 19 years.
We’ve had a big fall. For the perpetrators of the attack on America, the biggest success has been the injection of fear into the national psyche. Not even they could imagine how social media could turn fear into contagion and how the politics of fear would help propel a buffoon with feral instincts to the White House.
Looking back over the years since the attack that bright September morning — it was my daughter Adele’s 4th birthday and she had just recovered from an infection so serious I had to hold her little body while doctors performed a spinal tap — I am reminded of lines from Hemingway’s “The Sun Also Rises.”
“How did you go bankrupt?” Bill asked.
“Two ways,” Mike said. “Gradually and then suddenly.”
First, there was the downward glide: the misbegotten war, the soldiers and shoppers, financial implosion, impunity for the mighty, recession, anxiety and polarization. Then Americans, and not only Americans, decided it was better to blow things up than have more of the same. That’s when things precipitated.
The esteemed leader won even though Americans know he makes stuff up and wants a victorious small-to-medium-sized war that will allow him to proclaim American greatness restored. People do crazy things. They invade Russia, for example. Just look at history. Trump might think bombing Iran is his ticket in 2020.
What is all the fear about? It’s the loss of sanctuary. Menace could be anywhere since it came out of a clear blue sky. It’s the loss of victory. There is none to be had. It’s the loss of confidence. America’s power is greater than its ability to use it. It’s the loss of community. Technology is a great connector but also a great isolator. It’s the loss of self-worth. Life in the Facebook age can become an endless invitation to feel inferior or unloved.
All of this has fed a tissue of fear and disquiet easily exploited by the esteemed leader, whose instincts are above all for human weakness.
Hence Muslims and Mexicans and Mullahs and trade manipulators and all the other menaces to America that the leader deploys as needed.
In “The Sun Also Rises,” Hemingway wrote something else: “It is awfully easy to be hard-boiled about everything in the daytime, but at night it is another thing.”
It’s hard to shrug off the darkening skies. The worst of 9/11, almost a generation on, is the feeling that the perpetrators won. They didn’t buckle Western freedom and democracy, but they injured them. They disoriented the West. They sucked some of the promise out of a new century.
The assassins of Abraham Lincoln and Mahatma Gandhi and John F. Kennedy and Martin Luther King took the lives of great men but did not destroy their ideas. Perhaps they reinforced the immortality of those ideas. The assassin of Yitzhak Rabin and the mass murderers of 9/11 dispatched by Osama bin Laden were, however, more successful.
Yigal Amir, Rabin’s killer, uprooted the Oslo seeds of peace by assuring that Israeli Messianic-nationalist religious ideologues got the upper hand over secular pragmatists. They have never relinquished it. Bin Laden sapped America’s confidence, wove fear into the nation’s fabric, and inspired a metastasizing form of jihadi fanaticism that continues to terrorize the West in the crazed pursuit of a restored caliphate.
And Humpty Dumpty wants to build a wall he can sit on to contemplate xenophobia and Islamophobia.
I broke down a couple of days after 9/11 when I saw an image of a woman’s ultrasound stuck on a subway wall at 42nd Street with the words: “Looking for the father of this child.” Perhaps, in retrospect, my sobs were for all the innocence lost that day, the dreams unborn.
Adele was very brave through the spinal tap. Today she’s a brave young woman. They are out there: the brave, the stoical, the imaginative and the decent. Despite everything, they will have their day.