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The Goldwater rule: Why psychologists can’t diagnose Donald Trump from afar

In casual conversation, it’s common enough to hear people casually “diagnose” Donald Trump as “crazy” or similar.

But psychologists themselves, for the most part, stay silent.

That’s because of something called the “Goldwater rule”, a convention that means it’s unethical for the people who would know best to make any comment on the mental health of public figures.

The Goldwater rule governs what psychologists can comment on

The Goldwater rule is the casual name for Section 7 of the American Psychiatric Association’s The Principles of Medical Ethics – which effectively means it’s a convention that guides how most psychologists in the United States act.

Here’s the relevant section:

On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorisation for such a statement.

In effect, it says psychiatrists should not diagnose people from afar, that they can comment on mental health issues in general and that they need permission from a patient to say anything even if they have examined that person.

It’s named after Barry Goldwater, who ran for President against Lyndon B Johnson in 1964, and was prompted by a magazine article that polled psychiatrists about whether he was “fit” to govern.

It protects public figures – and everyone else

The Goldwater rule is intended to protect people from uninformed speculation about their mental health in public from a source that might be seen as expert. Unless a psychiatrist is your psychiatrist, they’re not qualified to talk about any diagnosis you may or may not have.

As a side effect, it protects public figures from attack for the sake of clicks, viewers and sales. Accusing a divisive political figure of mental illness because of a radical policy draws the debate away from the policy itself, and speculating on the mental health of celebrities on the gossip pages could set a misleading and damaging example.

But there’s been a fightback

Donald Trump visiting his golf resort in Aberdeenshire last year (Photo: Getty)
(Photo: Getty)

Not everyone is still on board with the Goldwater rule – mainly because of the rise of Donald Trump.

The American Psychoanalytic Association – that’s Psychoanalytic, not Psychological – circulated a memo to its 3,500 members last month that was seen as relaxing the strict rule. “We don’t want to prohibit our members from using their knowledge responsibly,” said past president Dr Prudence Gourguechon.

And for the past year, Psychology Today has debated the ethics of calling the President crazy, or a liar. The Goldwater rule isn’t seriously under threat, but many psychologists believe it’s fine to call the President a narcissist in layman’s terms – as long as they don’t diagnose him as a narcissist (i has an article on this subject with quotes from several professionals).

It’s worth noting that the rule doesn’t carry any penalties to deter people from breaking it. The association could censure a member for doing so, but that “has apparently never happened”.

Is it worthwhile?

To some commentators, the principle is deep. One article in the Guardian claimed that “mocking a person for their (supposed) mental condition is no different to mocking someone for their physical disability”.

Another, in New York Magazine, took the other side, stating: “Given how emotionally charged the debate over Donald Trump’s strange, frequently abusive behavior is, it would be useful to have more expert voices participating – the benefits clearly outweigh the costs.”

But the stakes are, theoretically, high. Some in the so-called Resistance movement – the Hillary Clinton ultras who are devoted to Trump’s swift removal – are campaigning for Trump to be removed under the 25th Amendment due to what they claim is mental illness. Comments from psychologists clearly have the potential to feed such speculation.

It applies in Britain too

People who work in psychology in the UK don’t follow the APA rules, of course, but there is very similar guidance in place.

A spokesman for the British Psychological Society said: “Our ethical guidance to members in this area is not to comment on the mental health of an individual without having met them in a clinical setting, which applies equally to public figures.”

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