Sunday, March 20, 2016

Maybe You're Crazy

"Psychologists Break Professional Silence To Diagnose Trump For Public Good." How's THAT for a headline? More on that in a moment.

I know a number of people who are politically engaged, and  common topic of conversation for them is the role of "the Media" in public life, especially elections, now that it's campaign season. I usually wind up rolling my eyes, because, to me, many of their portrayals of "the Media" come across as subtle, yet inescapable mind control, perpetrated by a shadowy cabal of hateful élites who spend their time in darkened rooms plotting how best to make everyone firmly believe The Wrong Things. But, for all that, sometimes you can find stories where "the Media" should have known better, and while I suspect that pageviews and/or advertising dollars were the driving factor here, the fact remains that there's something fishy afoot.

Back in November, Vanity Fair published an article, with the click-bait title: "Is Donald Trump Actually a Narcissist? Therapists Weigh In!" which purports to have a number of mental-health professionals tackling the question of "What exactly is wrong with this strange individual?" To lend gravitas to the piece, which includes quotes from psychologists and psychotherapists, Vanity Fair notes:

That mental-health professionals are even willing to talk about Trump in the first place may attest to their deep concern about a Trump presidency. As Dr. Robert Klitzman, a professor of psychiatry and the director of the master’s of bioethics program at Columbia University, pointed out, the American Psychiatric Association declares it unethical for psychiatrists to comment on an individual’s mental state without examining him personally and having the patient’s consent to make such comments. This so-called Goldwater rule arose after the publication of a 1964 Fact magazine article in which psychiatrists were polled about Senator Barry Goldwater’s fitness to be president. Senator Goldwater brought a $2 million suit against the magazine and its publisher; the Supreme Court awarded him $1 in compensatory damages and $75,000 in punitive damages.
And it is this passage that inspires the Reverb Press headline in their own article from late last week.

But I actually read the Vanity Fair article, and something struck me right off the bat. If Barry Goldwater was awarded $75,001 in damages after an article in which psychiatrists violated what is now the "Goldwater rule," why on Earth would Vanity Fair, or anyone else, for that matter, run an article that requires a violation of the rule? The answer is, as it almost always is: They didn't. Other than Professor Klitzman, there is not a single psychiatrist quoted in Vanity Fair. The mental health professionals they talk to are a developmental psychologist, clinical psychologists, a psychotherapist and a licensed clinical social worker. And while you could make the point that the APA's rule against commenting on the mental state of individuals unknown to them personally and obtaining consent for such comments would be a best practice for them just as much as for a practicing psychiatrist, the fact remains that the Goldwater rule is not binding on them - for the simple fact that they aren't speaking as psychiatrists, even if most laypeople don't make, or understand, the distinction. And it's only within the context of blurring that distinction that the mention of the Goldwater rule makes sense. Because it likely would take a fairly deep and abiding concern about a situation to prompt someone to openly violate a point of professional ethics. But it's a much lower bar for most people to ignore the ethical rules of other professions, regardless of how much of a best practice that rule is. And the fact remains that while psychiatrists are mental-health professionals, not all mental-health professionals are psychiatrists, and the rules of the American Psychiatric Association don't apply to the mental-health profession as a whole any more than the fact that I write a weblog subjects me to the rules of the Society of Professional Journalists.

To be sure, there's nothing that says that journalists know everything that the rest of us don't. It's entirely possible (if not, in my opinion, terribly plausible) that this article was researched, written and edited without anyone realizing that reference to the Goldwater rule was at once irrelevant and potentially confusing. But then again, a lot of things are possible.

Reading the Vanity Fair and Reverb Press articles, I can understand how Donald Trump's supporters come to the conclusion that "the Media" is out to get him. If you see in this coverage of Mr. Trump an implication that mental-health professionals are willing to throw their ethics under the bus in support of an opinion piece cum hatchet job, it becomes easier to understand this comment by George Wooley, one of the people running to succeed former Speaker of the House John Boehner as a member of the House of Representatives:
The easy answer is to take the guns away from the mentally ill. The trouble is, the medical community has been co-opted by liberals who say that if you don't agree with abortion and homosexuality, there's something wrong with you. It's not hard to imagine that they could also declare people that are Republicans and conservatives as mentally unfit as well. So until we get this political correctness swept away with the truth, I say we keep the Second Amendment as it is.
For all this, I'm still not on the bandwagon of claiming that "the Media" are in the business of manufacturing consent for their oligarch masters. An article implying that Donald Trump is mentally ill may as well have "Trump Haters (of which there are many) Click Here" on it, in letters that can be seen from orbit. And that, like it or not, is their job - get people to click, to read, to subscribe in the service of keeping the money flowing. Serving the public doesn't always put food on the table in the way that serving those who want to sell to the public does, regardless of one's ethics. And it's always easier to sell something to the public that they already want.

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