Now, an op-ed in The New York Times by an anonymous “senior White House official” describes how deeply the troubles in this administration run and what effort is required to protect the nation.
None of this is a surprise to those of us who, 18 months ago, put together our own public service book, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.”
My focus as the volume’s editor was on Trump’s dangerousness because of my area of expertise in violence prevention. Approaching violence as a public health issue, I have consulted with governments and international organizations, in addition to 20 years of engaging in the individual assessment and treatment of violent offenders.
The book proceeded from an ethics conference I held at Yale, my home institution. At that meeting, my psychiatrist colleagues and I discussed balancing two essential duties of our profession. First is the duty to speak responsibly about public officials, especially as outlined in “the Goldwater rule,” which requires that we refrain from diagnosing without a personal examination and without authorization. Second is our responsibility to protect public health and safety, or our “duty to warn” in cases of danger, which usually supersedes other rules.
Our conclusion was overwhelmingly that our responsibility to society and its safety, as outlined in our ethical guidelines, overrode any etiquette owed to a public figure. That decision led to the collection of essays in the book, which includes some of the most prominent thinkers of the field including Robert J. Lifton, Judith Herman, Philip Zimbardo and two dozen others. That decision was controversial among some members of our field.
We already know a great deal about Trump’s mental state based on the voluminous information he has given through his tweets and his responses to real situations in real time. Now, this week’s credible reports support the concerns we articulated in the book beyond any doubt.
These reports are also consistent with the account I received from two White House staff members who called me in October 2017 because the president was behaving in a manner that “scared” them, and they believed he was “unraveling”. They were calling because of the book I edited.
Once I confirmed that they did not perceive the situation as an imminent danger, I referred them to the emergency room, in order not to be bound by confidentiality rules that would apply if I engaged with them as a treating physician. That would have compromised my role of educating the public.