What if talking about the madness of King Donald actually fights stigma?

September 24, 2017 § Leave a comment

Since the fall of 2015—during the presidential primary scramble, when I first became aware of his violent will to power—I’ve wanted to write about Donald Trump’s mental health, like everyone else. More specifically, I’ve wanted to reflect on all of the agonizing over whether it’s okay to write about Trump’s mental health, and whether that unfairly stigmatizes those with mental health diagnoses, from the standpoint of one with various and sundry diagnoses. I’ve held off because not only because so much ink has already been spilled on this topic (or so many frantic keystrokes, I guess) but also because I have so much to say about what’s already been said that it feels like the task of saying anything, or saying something concisely and coherently, would be exhausting. But here we go.

In a nutshell, cultural commentary over the past couple years has shaken down into various camps:

–those who see in Trump’s behaviors and statements clear evidence of narcissistic personality disorder and sociopathy

–those denying that Trump has NPD or any other mental illness because he doesn’t manifest any distress or impairment (most notably and recently Allen Frances, the psychiatrist who helped write the criteria for diagnosis of NPD in the most recent edition of the DSM-V)

–relatedly, those stating that “armchair diagnosis” by mental health professionals breaches an ethical standard known as “the Goldwater Rule”

–those maintaining that mental health professionals have a “duty to warn” above and beyond the Goldwater Rule

–those within the mad/disabled community who argue that in falsely equating his dangerousness with his mental health status, discussions of Trump’s mental health reinscribes stigma

It’s this last set of objections I care most about, as someone who is part of those communities and who lives with the weight of psychophobic and ableist cultural norms. From the Bitch Media column by s.e. smith, linked above:

The disability community remains unimpressed by the use of mental health descriptors [i.e. “crazy,” “demented,” “psychotic,” etc] as pejoratives, arguing quite rightly that they perpetuate stigma. My diagnosis is among those carelessly flung around to describe Trump, and I would be lying if I said it didn’t sting every time I see someone evoke it. Do people think that people like me—with a complex set of neurochemical imbalances that science still doesn’t fully understand, but that appear to be linked to both genetics and environment, factors both out of my control—are deplorable bigots? Is that what it means to be mentally ill? To espouse radically offensive policy proposals and to talk about other human beings like they are garbage?

However, one of the things I’ve been mulling over for the past two years as I’ve digested all this commentary, and which I still haven’t really seen articulated, is the possibility that discussion of Donald Trump’s mental health is actually an exercise in the destigmatization of mental illness–or at least an opportunity for such. I feel this way for a couple of reasons:

First, what does it serve other than normative shame and stigma to say that we can never speak publicly about the possibility that someone elected to public office may have a mental health condition? So many of us do. Undoubtedly many wrong-headed and ableist ideas about mental health and mental illness will be flushed to the surface in this discussion (for some examples, see this post about the #DiagnoseTrump hashtag on the disability justice blog The Mighty). But it’s also a moment to address and correct those assumptions, as s. e. smith does in carefully disentangling socially-produced norms and attitudes from illness or disability:

[W]hat does it mean when a bigot’s behavior patterns are used as the basis for calling him “mentally ill” or using other slang terms for mental illness … ? There’s not just a false linkage between mental health and social attitudes here, but an absolution.

Racism … is a mundane social phenomenon—it is everywhere, ubiquitous and surrounding us as a cultural meme. It is also something structured and built by society, which means that it is something that can be torn apart by society, if, that is, society is willing to do so. This applies to the entire basket of -isms that Trump endorses and perpetuates. To dismiss Trump’s attitude and the cultural movement surrounding him as mere “mental illness” is to abrogate responsibility for our own complicity in creating the world that made Trump and to shrug off the obligation to do something about it.

Second, what does it serve other than norms of shame and stigma not to talk honestly about the reality that the conditions we describe or understand as mental illness can at times lead us to act destructively–to cause injury to ourselves or others? To me this seems to drive much of the anxiety among madfolks about talking about the possibility that Trump, who is horrible and terrifying on so many levels, might also have some diagnosable mental health condition.

As a person with a history of mental illness, I am not horrible and terrifying. But yes, I do have a history of self injury, and yes, this behavior has at times created chaos and emotional suffering in my relationships for partners and family. Yes, at times when not well my partner has acted in ways that were scary to me, because they threatened violence. Yes, both of us have to work hard periodically to make sure that these internal dynamics–whether biologically-rooted or trauma-produced–don’t affect those we love. No, we are not bad people.

But I don’t think we should deny these aspects of madness, either. Go to any NAMI or DBSA or AA or Al-Anon meeting and you’ll realize that they are common. Our conditions themselves in both their creative and destructive aspects are simply part of the spectrum of ordinary human experience. To that degree, I think we should be more honest about this reality, more matter-of-fact, less ashamed to be who we are, so that we can better take responsibility for responding compassionately and effectively to the destructive aspects of madness, both in our personal lives and on a societal level. It should not be unthinkable that someone elected to high public office might also have a mental health condition that places them on the extreme end of that spectrum, such that they act very destructively without any insight whatsoever into their condition, and therefore without taking any responsibility for how it affects others.

And third: I find that thinking of Trump in this way, as a person with undiagnosed personality disorder or mental illness, paradoxically humanizes him, allowing me to feel some kind of compassion for him. He has a huge sucking wound at the center of him that no amount of attention or adoration can fill. His whole existence is organized around protecting and insulating that wound–not seeing it, not responding to it with compassion, not taking responsibility for it.

None of this means that I don’t think he’s dangerous–I absolutely do.  His lack of insight into how he is driven by that wound to humiliate others, his delight in that humiliation, his cruelty toward those he perceives as weak, his gut-level intuition that the fastest route to cult-like levels of adoration is by fanning the flames of white racial resentment–all of this makes his current position completely terrifying. But as a neurodivergent person with a highly stigmatized personality disorder diagnosis (among others), I don’t have any problem speculating that he is probably neurodivergent with a personality disorder. As a neurodivergent person, I know that this is less important than how he lives with it, whether he has insight into his condition and takes responsibility for its destructive aspects. As a neurodivergent person, and maybe especially as a neurodivergent person, I don’t have a damn problem saying that someone without insight into their own sociopathic and narcissistic traits has no business occupying a position of such great power over so many lives.

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