I have previously criticized psychiatrists who have regularly appeared on the air to identify a variety of mental illness that they have observed in President Donald Trump from afar. As I discussed in a prior column on the demise of the Goldwater rule, this is diagnosis without examination and often seems mixed with strong political judgments about Trump’s political positions. Bandy X. Lee, a professor of psychiatry at the Yale University School of Medicine, has been one of the most outspoken and last week urged House Speaker Nancy Pelosi to demand some ill-defined “hold” on the president pending psychiatric examination. Her position latest position is utterly bizarre but has been treated as a serious discussion point by some media like Salon magazine.
Lee previously served as the editor of the book “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” and has continually argued for removal on the basis for mental illness. I previously discussed the difficulties in pursuing such loose analysis as the basis for removal under the 25th Amendment.
Lee’s most recent call for some form of intervention by Pelosi seems utterly disconnected from the constitutional process. She bizarrely treated this as an office intervention. Lee told Salon that “As a co-worker, she has the right to have him submit to an involuntary evaluation, but she has not. I am beginning to believe that a mental health hold, which we have tried to avoid, will become inevitable.”
I am at a loss on this one. Does Lee think that Pelosi can “as a co-worker” force the President into an involuntary evaluation? The only provision from incapacity of a president is found in the 25th Amendment and it omits such a workplace evaluation process. As I previously discussed, Section 4 has, essentially, two avenues for dragging a president from the Oval Office. First, there is the mutiny option. A vice president and a majority of the Cabinet can agree that the president is “unable to discharge the powers and duties of his office” and notify Congress that the vice president intends to take over. If Vice President Pence could get eight Cabinet officers to sign a letter to that effect, he would immediately become the “Acting President.” But if the president then declares to Congress that “no inability exists,” Trump could resume his powers.
Pence and the rebellious Cabinet would then have to send another declaration within four days to the President pro tempore of the Senate and the Speaker of the House that says, more or less, don’t believe a word, he’s unfit. Once Congress had the second declaration, if not already in session, it would have 48 hours to assemble to debate the issue. It would then have 21 days to vote on the president’s fitness. To remove the president, two-thirds of both houses would have to agree. If Congress did not vote within 21 days, the president would get his power back.
Notably, Lee again seems triggered by policies or actions with which she disagrees. This latest call for co-worker intervention was due to the killing of Iranian Maj. Gen. Qassem Soleimani. I also raised concerns over this action as a possible assassination in violation of U.S. law and an act of war under international law. However, Trump is not the first president to attack individuals on foreign soil whether it was Osama Bin Laden or the attempt on former Libyan President Muammar el-Qaddafi.
Lee’s medical diagnosis is hard to untangle from her political judgment. She insists that this is “exactly what someone who lacks mental capacity would do.”:
“This is exactly the kind of dangerous event we foresaw as Donald Trump’s response to the impeachment proceedings, just as his pulling troops from northern Syria was a direct response to the announcement of an impeachment inquiry . . . In other words, he is extremely drawn to actions that would help him appear as if he has mental capacity, such as a ‘presidential strike’ against an enemy, while avoiding the proper procedures, such as briefing with Congress, that might expose his lack of capacity . . . What we do not expect from someone who lacks mental capacity is rational, reality-based decision making that is non-impulsive, non-reckless, and cognizant of consequences.”
She adds that his attacks on President Obama must also be treated as a reflection of his mental illness: “Since he is incapable of putting himself in another person’s shoes, he projects his own thoughts entirely onto others. Hence, we can deduce that what he has said about Mr. Obama has nothing to do with the former president but has only to do with the way he himself thinks.”
At points, Lee seems herself a bit adrift. When asked about the widespread criticism of her claims of mental illness, Lee responded “My critics do not have an argument. There are many situations where I hoped that my formulation would be wrong — but now that my hypotheses have been tested so many times to 100 percent precision.”
Really? She is 100 percent right without ever actually personally examining the subject.
Then the interview gets downright batty when the 25th Amendment is raised:
“Yes. In this country, no one is above the law, and as far as mental health laws and the president are concerned, there is no Office of Legal Counsel memo, no exceptions and at this time not even confidentiality, since he has yet to be a patient. Before it is a political matter involving impeachment or the 25th Amendment, it is a medical matter. The physical danger due to psychological impairment needs to be removed, and we are bound by our own professional code not to abandon persons or the public in danger. We are even legally bound to take steps to protect potential victims if warning is insufficient and security staff will not act. If the personal physician is unavailable or too conflicted to do so, any physician can.
A 72-hour hold does not require court intervention and is enough for a solid evaluation. There is no shortage of mental health professionals willing to put their names to commitment papers, and multiple legal groups have offered to file for a court order for security staff to cooperate. All we need are auspices so as to show it is not a coup or something nefarious — although, at this point, we may need to proceed anyway because the populace is growing too sick to see any intervention as legitimate unless it is illegitimate. This is common in mental health settings, and we apply the proper treatment according to standard anyway with the hope that patients will improve enough to see that you have helped them — which happens most of the time. It is this nature of mental disease that has allowed for civil commitment laws to be possible in a country that protects civil liberties.”
Could you imagine the future of our system if a Speaker of the House could have a president civilly committed for involuntary examination? Some Republicans would no doubt have asked Pelosi’s GOP predecessor for the same civil confinement of President Obama. We would need a regular presidential suite at St. Elizabeth’s. Lee herself shows the potential for securing favorable rulings from doctors who believe no sane person could hold certain political views or take certain actions.
It would be, in a word, madness.
Jonathan Turley, pleased that you have learned about St Elizabeth’s. More politicians belong there.
Jonathan Turley, she is a psychologist, not an MD with a residency in psychiatry. There is a big difference.
Check your sources. She *is* a psychiatrist and earned an M.D. degree.
To the partisans who put this story out, the whole point is THE HEADLINE. If it were an honest headline, then it would have read “Partisan Quack Shrink Violates Medical Ethics” or “Partisan Democrat Thinks Trump Is Nuts!”
You see,neither of those TRUE headlines would have the gravitas of “Yale Psychiatrist” in the title. But, I am sure Democrats will look only to confirming their bias and take this piece of crap to heart.
All a story needs for Democrats is the merest hint of “authority”, and they will lap it up. Or, the scent of theatrics, like the whole Greta Thunkbird thingy. Oh look! A 16 year old believes something! We should all go follow her! Never mind that she is about the same age as suicide bombers who are convinced they have it all figured out.
Criminy.
Squeeky Fromm
Girl Reporter
She is not a psychiatrist, merely a psychologist.
The shrink needs a shrink.
Has Dr. Lee interviewed Trump? I doubt it. Just because she teaches at Yale doesn’t mean that what she believes is correct. Unless she has sat down several times and talked with Trump she has no right to say anything about him. There were things like this said about Bush (II) as well as Obama. A comment like this is NOT newsworthy and doesn’t bear on word in print.
We would not have to entertain this whole stupid lying defamatory exercise against the President, staged by Yale’s wonky professor pscyh, and her handlers and financiers, if the case New York Times v Sullivan were not the leading case on defamation which allows organizations and newspapers and all such like as they to slander and libel public figures with impunity.
It should be reversed.
Apart from the obvious ethical lapse in the proposal, it reveals an infantile logic. This psycho fails to consider the very real possibility that what she sees from afar maybe a persona adopted by Trump. Just like Pelosi’s “prayerful” attitude or Buttigieg’s theology. I guess she never heard of Muhammad Ali who could whip himself into a frenzy to unnerve his opponents even to the point of elevating his heart rate.
I guess that would require serious thought.
Mentally ill psychiatrists calls on mentally ill Pelosi, “To Put “A Mental Health Hold” On Trump”. Only persons with TDS could think up such BS.
Physicians and research scientists read the New England Journal of Medicine online and rarely are comments posted on their website. However on this particular topic, in 2018 in an opinion piece, physicians comments number near 100, something I have never seen. Some are quite funny
A random sampling follows with none edited nor taken out of order…
President Trump’s Mental Health — Is It Morally Permissible for Psychiatrists to Comment?
February 1, 2018
N Engl J Med 2018; 378:405-407
DOI: 10.1056/NEJMp1714828
Ohad Guetta
Jan 31, 2018
Ohad Guetta
Physician, Internal Medicine
Disclosure: None
Israel
This is a joke
This article is a mokery of a frustrated pseudo-intelectual proffesional.
It seems that the editor of NEJM is on a break from ethical principles.
Lee Fouts
Jan 31, 2018
Lee Fouts
Other
Disclosure: None
Are you kidding me?
To even give this subject space in such an esteemed publication as the NEJM is an insult to intelligence. To dignify speculations regarding a mental health evaluation based on TV appearances is just plain stupid and most likely a cloaked expression of political bias.
PATRICK HUNTER, MD
Jan 31, 2018
PATRICK HUNTER, MD
Physician, PEDIATRICS
Disclosure: None
ORLANDO FL
Sad
I feel sad for my profession. When I started, it was a calling to care for people. Not dissimilar to the clergy, education or the law. We all know that education and the law is fully politicized. Often the clergy too, if not just dismissed out right as no longer relevant to “modern life”. Medicine is now fully politicized, as we all take sides. Even worse, medicine has become big corporate business, where the patient is an asset to the financial bottom line.
Medicine, once a proud profession, is now more about money and politics. Damn the patients.
Yes, almost 30 years in, I still have a hint of the idealist medical student who wanted to help his fellow man. I hope some of that idealism is still present in the exam room, when I am trying to help a patient.
I think most of our fellow men and women have lost faith in our teachers, our politicians, our attorneys and the clergy. And also, if you believe the polls, and it shouldn’t surprise you based on how we as a profession have become politicized and corporatized, they have lost faith in the profession of medicine.
I don’t blame them.
DAVID MORTON III, MD
Jan 31, 2018
DAVID MORTON III, MD
Physician, UNSPECIFIED
Disclosure: None
LITTLE ROCK AR
Just Another Hit Piece on Trump
Just another hit piece on president Trump, disguised as a professional analysis. The real purpose of this article is to attempt to smear Trump and rationalize unprofessional conduct of analysis at a distance by psychiatrists ad psychologists, through the media. I think Trump’s actions, especially while being constantly attacked by media and psychiatrists who just don’t like him, are admirable. His achievements for the country are stunningly successful. Again, this is just another boring, irrelevant hit piece of little value. The Goldwater Rule was correct and will always be correct and it’s really pretty irritating to see doctors try to rationalize their way around it for their own emotional satisfaction disguised as professionalism.
H SILVERSTEIN, MD
Jan 31, 2018
H SILVERSTEIN, MD
Physician, CARDIOVASCULAR DISEASE
Disclosure: None
HARTFORD CT
The Forest
Claire Pouncey, MD, like so many, misses the forest for the trees. She confuses style with substance. The public and his supports care what he has accomplished: the rest is theatrical fluff that is simply different in format from his predecessors. H. Robert Silverstein, MD, FACC
SERGIO STONE, MD
Jan 31, 2018
SERGIO STONE, MD
Physician, GYNECOLOGY
Disclosure: None
VILLA PARK CA
NO
NO, nothing to comment if medical ethics and the law is to be followed. Would they comment on a patient they see down the street without examining him or his permission?
ROBERT HENNESSY, MD
Jan 31, 2018
ROBERT HENNESSY, MD
Physician, FAMILY MEDICINE
Disclosure: None
Corona CA
Really funny
Every “chin pulling” grave diagnosis by Mental Health “professionals” that I’ve seen demonstrate severe dissociation from reality on the part of the “evaluator” and not Trump! When you strongly dislike a person, it’s best not to opine too much about them.
WILLIAM CROMIE, MD
Jan 31, 2018
WILLIAM CROMIE, MD
Physician, Pediatric Subspecialty
Disclosure: None
Albany NY
Trump Derangement Syndrome
The location(Blue States,)Political affiliation,and unfortunately sex, may be disqualifying factors for any credible opinion rendered by volunteer armchair psychiatrists(none having interviewed Trump nor reviewed his 100% Montreal Cognitive Score).Even surgeons have long understood that individuals seeking this office have a strong narcissistic bent, have deep egomaniacal tendencies and with time develop delusions of grandeur( Obama actually thought he was King). Anyone willingly entering the political arena currently has to be totally out of their mind, so let’s all go with it, and not try to quantify and classify, and in the case of Trump, pile on.sanctimoniously.
Perfect, estovir.
You couldn’t be more wrong. First in your ridiculous testimony and now this? Take a step back & learn something about narcissistic sociopaths. This has never been about politics. You are part of the problem,
Motek – I know a few narcissistic sociopaths. I actually think that you cannot be a good president without being a sociopath. However, Ms. Lee’s comments are about politics.
Dr Lee’s articles are mostly about Dr. Lee and her justification she gives herself for being that so brilliant that she is the one she would choose to perform the evaluation, since, after all, she is a professor so is devoid of political intent. According to her self assessment, she is as pure as driven snow and most capable, certainly not needing assistance with evaluations she undertakes with the purest intent.
DLVN – doesn’t she realize that her co-workers could sent her away at will?
Thanks Paul…
It is a known fact that pretty much ALL executives and THOSE in positions of power, have some level of Narcissism, Sociopath, or Psychopathic tendencies.
I can speak on Narcs for sure…
But there are some many types. Cerebral Narcs (met a lot of them), Somatic Narcs (a ton in LA)…and then you have your Overts and your Coverts.
Overts are super easy to spot, and IMHO less dangerous (b/c hey, at least you know up front where you stand with them, e.g., you know from their words and actions if you’re in the “good” club or their “sh!t list.” And I will tell you what being in the “dog house” with these types is a huge pain).
Then, of course, your garden variety Coverts, and these types come in all shapes and sizes, and I think they’re more dangerous b/c you think you’re in the “good” club, and then, BAM….they hit you with something, and you find out, you were “oh so wrong.” Coverts like to play the “victim” a lot, and I mean, on anything. They’re offended by you b/c you blinked in a manner they found offensive.
And then we have Benign Narc, which I find fun to be around, and rather entertaining; but then, you have Malignant Narcs, and they are very close to a Sociopath, and rather scary, e.g., they steal your stuff when you’re not looking, and claim they saw nothing, they damage your property and blame it on a “ghost.” They’re competitive to a fault on literally everything, i.e., you are sick, they are no sicker than you/you buy something, not only will they go buy the same thing the very next day, but they may just buy two, so they have a spare. Gotcha!
Here is a good one, this one happened to me recently, you tell them you’re allergic to a food item….Guess what we are all eating for Xmas dinner!!!
Or even better, you told them like forever ago (10 year ago) you hate a certain band….Guess who loves that band now (and yes, they were playing the music when I stopped by….what!? it’s their favorite band! duh!)
Oh wait, my super most fav recent one (being sarcastic). Your beloved pet died a few years ago.
Sending you photos of your deceased cat with the words, “Sending you kitty love!”
I’m actually wondering if some of these ppl, with these various personality disorders might be demonically possessed…def pondered the thought.
WW33 – an exorcism could be in order. 😉
Haha…. 😉
You know I read an article not too long ago about how “psychopaths” end up living in and around D.C. Not sure if they move there, or if they develop tendencies from being there. It was by Politico. And, I am not saying all, I met a lot of very nice and normal spectrum ppl in D.C.
https://www.politico.com/magazine/story/2018/06/23/washington-dc-the-psychopath-capital-of-america-218892
Here is another article about Narcs and Corporations….not the one I was looking for, but good enough….
https://www.forbes.com/sites/nazbeheshti/2018/10/19/can-a-narcissistic-ceo-destroy-their-company/#152187514b02
Essentially, since the energy trickles down, a Malignant Narc as say CEO can leave a major lasting mark on other managers, and it could take a decade plus to rid the place of the toxicity.
Mr. Turley, how do you live with yourself? THIS IS NOT A DRILL and it’s not about politics. It’s about public safety. Your propaganda is putting lives at risk. According to National Security Experts and TENS OF THOUSANDS of mental health professionals, Trump is our greatest national security threat.
Donald Trump is a clinical malignant narcissist (aka narcissistic psychopath in this case). It is easier to diagnose a personality disorder in a natural setting than a clinical setting and we have thousands of hours of video of Trump in his natural environment. Psychiatrists have a ‘duty to warn’ when someone is a threat to themselves or others and he is most certainly a threat on an international scale.
He is ignorant. incoherent and easily manipulated by the dictators he worships, but what what makes him most dangerous is that he lacks a conscience. Your willingness to lie to Congress and allow Republicans to blow up the world is unethical, illegal and very disturbing. You have not provided a counterpoint to Dr. Lee’s expert observations. Anyone as rage-filled, irrational and untethered to reality as Trump, should absolutely be on a psych hold.
Also, may be important for your readers to note that you had very different feelings about impeachment when it was a Democrat who had an affair vs a Republican who is a national security threat.
https://thehill.com/opinion/judiciary/473227-the-shifting-impeachment-positions-of-jonathan-turley
Yup.
SHB:
“He is ignorant. incoherent and easily manipulated by the dictators he worships, but what what makes him most dangerous is that he lacks a conscience.”
*************
Now scientistofhumanbehavior may be a gifted satirist. The comment is amusing for its outlandishly wrong observations, even if a tad disjointed. If really a scientist, he/she’s a bad one relying on another’s observations (typically the slanted MSM) for a scientific conclusion that belies the facts like crippling sanctions and new missiles pointed at these dictators. If he/she’s a physician, it’s malpractice to diagnose without a basis in fact. So either a clown, fraud or quack. You decide!
I’m going with clown – doesn’t seem bright enough to achieve the other two. The nonsequitur slur against JT being the tell.
Except there were 11 findings that laws had been broken by the President in the Clinton impeachment. Clinton didn’t get disbarred for having a slap and tickle with a teenage intern.
The shiny object chased by you moppets is that it was “about sex” yet I guarantee that you have no problem with General Flynn being prosecuted for lying about an event that violated no laws. Or with Roger Stone spending his dying days in prison for lying about a crime that did not happen while at the same time producing documentary evidence to undermine his own words.
For the record, I think all three should have been pursued. Our system of justice depends on our ability to obtain truthful testimony. When we cannot we run the risk of perverting justice or having a frustrated government resort to extracting testimony under torture.
Scientistofhumanbehavior – your post sounds “rage-filled, irrational, and untethered to reality.” Ironic.
Don’t weaponize mental illness diagnosis for political purposes.
If you are a mental health professional member of the APA, your comments are in violation of the American Psychiatric Association’s Goldwater Rule, put in place from another time when psychiatrists suffering from political poisoning abused their position to attack a Republican presidential candidate. However, based on your statements, your avatar seems unlikely.
Seems to be a trend in this troubled profession.
A wonderfully deranged reply. Amusingly disjointed, illogical and plainly emotionally driven. Trump has been remarkably restrained given the delusional and largely inaccurate reporting about his actions as President. He as been far more restrained than his predecessor, and has maintained an administration that has high regard for both law and precedent. He has been judicious in his behavior toward political figures who oppose him, bringing a calmness to the Presidency that appears to frustrate his opponents who often strike out at him using generalities usually unsupported by any evidence, very similar to your presentation.
When I studied medicine I could not distinguish a psychiatrist and the patient
I assume that you flunked.
Let’s hope.
On the high prevalence of mental disorders in psychiatrists:
There is also a high suicide rate in psychologists, with some studies suggesting that close to 30% have felt suicidal and nearly 4% have made a suicide attempt.3 One study of more than 1000 randomly sampled counseling psychologists found that 62% of respondents self-identified as depressed, and of those with depressive symptoms, 42% reported experiencing some form of suicidal ideation or behavior.4
Beyond the stresses of being a psychiatrist, psychologist, or other mental health professional, there are several reasons some practitioners of these disciplines may be vulnerable to mental health disorders.
“Many people choose to enter the mental health professions, at least in part, because they want to examine their own, or their family’s, psychological issues, vulnerabilities, or pain,” according to Stephen Hinshaw, PhD, professor of psychology, University of California, Berkeley, and professor of psychiatry and vice-chair for child and adolescent psychology, University of California, San Francisco.…
A 2015 survey of Canadian psychiatrists found that of 487 psychiatrists who responded to a questionnaire, nearly one third (31.6%) said they had experienced mental illness, but only about 42% said they would disclose this to their family or friends.”
https://www.psychiatryadvisor.com/home/topics/mood-disorders/depressive-disorder/challenging-stigma-should-psychiatrists-disclose-their-own-mental-illness/
When I went to a university, it was my observation that psychology students all seemed to be looking for self diagnosis. Published articles appear to support this anecdotal experience.
Reread Brandy Lee’s meanderings sometime. She is perceptive, however, she finds it necessary to defend her engagement as if she knows she is stepping over the line, but with just one more explanation, her transgression is acceptable. (it isn’t). She wields defensiveness as usefully as an inpatient in a mental hospital.
This was a reply to David Benson that was mis-sorted in the thread.
Very interesting article about this. He’s gotta a point tho.
So……the argument is dont hold a simple medical evaluation, because, who is this coworker, Speaker of the House no less, to ask the President about his mental health?
Given his daily overtly erratic behavior?
So according to you Professor Turley, he seems perfectly fit because – reasons, and therefore is IMMUNE from yet another routine system of checks?
What’s disappointing is scholars like yourself who have spoken for all to hear complete fealty for this clear and present danger in the White House, which, if we’re talking behavior, does not follow the logical pattern of any argument that would require your absolute support.
MAKES NO SENSE
“Complete fealty” to Trump? Apparently you don’t read his blog. Why don’t people take 5 minutes to research?
President Trump passed a health exam upon entering office. Not agreeing with him does not make him mentally ill.
Shame on all of you, weaponizing mental illness diagnosis because you want to get rid of the President, and don’t want to have to rely on voting.
There is a Walking Dead of people who really are mentally ill and unstable, lurching around CA. If you want to see someone who really can’t function, come to Southern CA or San Francisco. There are people who think they see outer space aliens, who defecate inside grocery stores, who can’t manage to brush their hair in the morning or put their pants on. Then, take a good long look at your conscience for making such an accusation against a political opponent. You don’t call people mentally ill because you don’t want to risk losing the next election.
Is this what you want both sides to do?
Why Prof. Turley assume he knows enough about medicine to judge Dr. Lee’s comments wrong? He does not. Is it because they are inconvenient for the personality he supports?
Interesting comment
Since you have never been President, you will refrain from judging President Trump right?
Nahhhh, I didnt think so either
That chick, Bandy Lee….phew! What a quack!
it’s defamation per se to claims falsely that someone suffers from mental illness. that’s a legal fact. we only need a law degree to sue somebody for it. not a medical degree. the proof of fact for the defense is what requires an expert witness
acronomon says there’s a lack of qualifications?
the main lack of qualifications to understand here, is that Bandy Lee never examined Trump, so her claim is baseless in fact and unethical speculation in itself. pure defamation
Kurtz, I am glad you made your point crystal clear. It is amazing how people are unable to understand lay medical ethics and lay law yet they can draw so many conclusions without any foundation.
ANALYZE THIS: https://youtu.be/mlz3-OzcExI