Regular readers of my column know that I’ve been sounding the alarm over Trump since the week following his election. His impulsive warmongering and scorched earth environmental policies imperil the entire world. His Breitbart love, wall fixation, Muslim ban, and Nazi enabling reveal a deadly racism that is antithetical to human progress. As such, I support any legal means necessary to see Trump removed from power.
Because of the mounting evidence of his criminality, I wish for a speedy resolution to Robert Mueller’s investigation. Because of the ever-growing evidence of his mental instability and resulting dangerousness, I continue to clamor for Congress and/or Trump’s cabinet to act upon Section 4 of the 25th Amendment, declaring Trump psychologically unfit for the presidency.
It is on this latter point that I must part ways with my professional organization, the American Psychiatric Association (APA).* Distressingly, since the beginning of this year, the APA has been riding a train away from moral and social responsibility. Their “Goldwater Rule,” in place since 1973, bars its members from making public pronouncements about prominent figures, without conducting a personal evaluation and obtaining that individual’s informed consent.
But at a time when the Goldwater Rule needs a nuanced interpretation, the APA has doubled down on its rigid, exception-free application. From here on, I’ll let my letter to the President of the APA speak for itself:
Dear Dr. Everett:
This letter is to notify you that, effective today, I am resigning from the APA, due to its inflexible adherence to the Goldwater Rule.
I believe that this ethical rule is appropriate the vast majority of the time. However, like most ethical rules, exceptions need to be allowed for exceptional circumstances. For example, though I live nonviolently, I would resort to violence to defend myself or others from imminent physical harm, as I was prepared to do when I counter-demonstrated against white supremacists earlier this year. And though I strive to be consistently honest, I would lie to prevent deportation of a refugee. (Sadly, neither of these hypotheticals is terribly hypothetical in America 2017.)
We are living in such an exceptional circumstance, when it is ethical to consciously and deliberately contravene the Goldwater Rule in the case of Donald Trump. Without making a definitive diagnosis, it is nonetheless plain to see that Trump exhibits antisocial traits and utters delusional statements, both of which appear to render him psychologically unfit for office, at a minimum necessitating an immediate evaluation by impartial professionals.
It is axiomatic in mental health practice that the best predictor of future violence is a past history of violence. Currently, the Oval Office is occupied by a man with an abundantly documented history of verbal, physical, and sexual violence. Here again, the failure to educate and warn the public, to act in the interest of national and international safety, is disgraceful.
Writing as one trained in psychotherapy, it is tragically ironic that your gag rule re-enacts the dynamic of an abuser in a domestic violence situation. As I’m sure you know, an abusive partner compels those under his thumb to deny their own thoughts and feelings, to disregard their internal danger signals.
In a disturbing parallel process, this is what the APA now expects of its members. As a mental health professional, I recognize the instability and danger the POTUS represents. In the face of this, the APA’s inflexibility would demand that I deny the evidence presented to my senses, the conclusions derived from my clinical experience and powers of reasoning.
In his magisterial work, The Nazi Doctors, Robert Jay Lifton aptly cites “Albert Camus’ insistence that we be neither victims nor executioners, that we avoid institutions and actions in which these two categories come into being.” As a psychiatrist, I find it intensely upsetting that my professional organization, by demanding silence of its members, only heightens the danger already facing those who aren’t white or inordinately wealthy in Trump’s America, not to mention all of us threatened by his impulsive finger on the nuclear trigger.
In its dereliction of its duty to sound the psychological alarm for the American public, the APA not only shares responsibility for Trump’s victims, but as a silent enabler even shades into the territory of executioner. I hope – for the sake of our world, our nation, our profession, and for your own consciences – that you will reconsider your stance on the Goldwater Rule. If or when you do, I will happily rejoin the APA.
Andrew L. Spitznas, M.D.
If you are a mental health professional, please feel at liberty to plagiarize or modify this letter, should you elect to resign from your professional organization for similar reasons. This is the one and only time as a writer that I will encourage plagiarism. Heck, for those who do so, I would clasp your hand in glad solidarity and fellowship.
I am sincere in my hope that the APA will revisit their stance on the Goldwater Rule. I see their present moral cowardice as a “circle the wagons” maneuver that aims to protect their organization from a lawsuit-happy Bully in Chief. Perhaps dwindling membership rolls will pragmatically trigger a reconsideration.
*To forestall any questioning on this, resigning from the APA does NOT affect my freedom to practice psychiatry. My specialty board certification is under the auspices of a separate entity. In leaving the APA, I cannot be disciplined by a state medical board for speaking out in violation of the Goldwater Rule, since state boards are governmental entities bound by the U.S. Constitution and its guarantee of free speech.
(Image credit: Public Domain)