Presidential Mental Health, Risks Of A Public Diagnosis

Narcissists, sociopaths, hypomaniacs and more: from Trump to Erdogan and Duterte, the debate on the stability of government leaders has become increasingly relevant. Labeling them as mentally ill or giving too much power to psychiatrists is dangerous.

Through the looking glass
Through the looking glass
Jessica M. Masucci

MILAN — House of Representatives speaker Nancy Pelosi supported a bill last month proposing the establishment of a committee of physicians, psychiatrists and high-profile personalities, including former presidents and vice-presidents, to judge the physical and mental capability of those who sit in the Oval Office.

Beyond its political significance, this proposal is part of a broader debate on Donald Trump"s sanity, with the past four years consumed by articles, books and interviews seeking sociopathological insight into the president's behavior.

In recent weeks, the New York Times noted Trump's "inability to express empathy" towards African Americans, as demonstrated during an interview with Watergate investigative reporter Bob Woodward for his latest book, Rage. In early September, an association of psychologists and psychiatrists that calls itself "Duty to warn" published a documentary titled #Unfit: The Psychology of Donald Trump. It argues that the president is a "malignant narcissist" — that is, suffering from a narcissistic personality disorder mixed with other alarming features not part of the official diagnostic manual on mental disorders.

The documentary's website clearly states that the film is not actually intended to offer a diagnosis, but as a warning to Americans and the rest of the world. For these specialists, it is a duty to warn citizens of the dangers of a disturbed president. Among the founders is Dr. John Gartner, author of a 2008 psychological biography on Bill Clinton, who he determined has a hypomanic temperament.

Still, we must ask what is the proper place of psychiatrists' views on a nation's leadership. In the United States, the Goldwater rule is a principle of medical ethics created by the American Psychiatric Association which urges doctors not to voice their opinions on public figures they have not personally examined. Yet for those who support a "duty to warn," the Goldwater rule must be bypassed in some circumstances so citizens can be made aware of the psychological condition of the person holding the briefcase with the nuclear codes.

The tension in the relationship between mental health and political power extends well beyond America's borders. In recent years, several major international newspapers have published articles on the mental state of politicians, such as President Recep Tayyip Erdogan of Turkey and Rodrigo Duterte of the Philippines. In 2016, a psychological study on Duterte, carried out years earlier on the subject of his annulled marriage, was published, stipulating that he suffers from both antisocial and narcissistic personality disorder. Italy has posed similar questions in the past, such as the alleged cyclothymia attributed to Francesco Cossiga and the alleged sex addiction of Silvio Berlusconi.

We must ask what is the proper place of psychiatrists' views on a nation's leadership.

Does it make sense, then, to question the mental disorders of prime ministers or presidents? Shouldn't we judge them only their political actions?

"We must be careful when making a diagnosis based on political actions, which are indirect diagnostic instruments — and then feeding it into public opinion," warns Patrizia Catellani, professor of social psychology at the Catholic University of Milan.

Labeling a politician as mentally ill also risks "stigmatizing the disorder," stresses Alessandro Amadori, a public opinion expert and partner of the Piepoli Institute. "We must not forget that the vast majority of people suffering from mental illness are harmless, and at most only harm themselves, not others."

Amadori says the question is not so much whether to discuss in the media the state of mental health of this or that leader, but rather to try "to prevent, as we do with airplane pilots, that people with certain mental disorders wind up holding such great power in their hands."

Trump and Duterte meeting in Manila in 2017 — Photo: Karl Norman Alonzo and Robinson Niñal Jr.

While we are waiting to develop a safeguard against mentally unfit people from coming to power, the discussion in the media continues. Therefore, we also need to assess what effect this has on individuals when they constantly hear about the (in)sanity of politicians on TV and Twitter.

"We tend to have a very rationalistic view of politics. In reality, politics always goes with a profound emotional investment, and the relationship between the voter and the leader is often a messianic one," Amadori adds. A media debate on the topic can only wind up radicalizing the positions of supporters and opponents, he says, "because it is read as an attack to disqualify one's object of love" by the former, while "galvanizing" opponents.

But since the pathological narcissist leader still needs a base of citizens willing to follow him, how is this bond formed? One hypothesis is that some people experience deep dissatisfaction and look for culprits. "The answer to this dissatisfaction could take two paths," social psychology professor Catellani explains: "one is collective protest, the other is collective narcissism, which is to say "I believe I am the best and I respond to my disadvantage by showing hostility towards others.""

The relationship between the voter and the leader is often a messianic one.

At this point it is legitimate — though problematic — to ask whether it is worse to be ruled by an alleged psychopath or to entrust psychiatrists with the judgment about what constitutes good governance.

There is a term that shows all the ambiguity of entering the gray areas of the relationship between power and madness: pathocracy. The word, which describes a form of government in which psychopaths dominate, was coined by Polish psychiatrist Andrzej Łobaczewski, a member of the resistance during World War II. However, if you search "pathocracy" on Google, you'll find a conspiracy website with a list of "psychopaths who rule the world." It goes from Bill Gates to Benjamin Netanyahu, by way of George Soros, Paul Kagame and Margaret Thatcher.

Be warned, the list is only partial — by tomorrow, any name could be added.

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How Thailand's Lèse-Majesté Law Is Used To Stifle All Protest

Once meant to protect the royal family, the century-old law has become a tool for the military-led government in Bangkok to stamp out all dissent. A new report outlines the abuses.

Pro-Democracy protest at The Criminal Court in Bangkok, Thailand

"We need to reform the institution of the monarchy in Thailand. It is the root of the problem." Those words, from Thai student activist Juthatip Sirikan, are a clear expression of the growing youth-led movement that is challenging the legitimacy of the government and demanding deep political changes in the Southeast Asian nation. Yet those very same words could also send Sirikan to jail.

Thailand's Criminal Code 'Lèse-Majesté' Article 112 imposes jail terms for defaming, insulting, or threatening the monarchy, with sentences of three to 15 years. This law has been present in Thai politics since 1908, though applied sparingly, only when direct verbal or written attacks against members of the royal family.

But after the May 2014 military coup d'état, Thailand experienced the first wave of lèse-majesté arrests, prosecutions, and detentions of at least 127 individuals arrested in a much wider interpretation of the law.

The recent report 'Second Wave: The Return of Lèse-Majesté in Thailand', documents how the Thai government has "used and abused Article 112 of the Criminal Code to target pro-democracy activists and protesters in relation to their online political expression and participation in peaceful pro-democracy demonstrations."

Criticism of any 'royal project'

The investigation shows 124 individuals, including at least eight minors, have been charged with lèse-majesté between November 2020 and August 2021. Nineteen of them served jail time. The new wave of charges is cited as a response to the rising pro-democracy protests across Thailand over the past year.

Juthatip Sirikan explains that the law is now being applied in such a broad way that people are not allowed to question government budgets and expenditure if they have any relationship with the royal family, which stifles criticism of the most basic government decision-making since there are an estimated 5,000 ongoing "royal" projects. "Article 112 of lèse-majesté could be the key (factor) in Thailand's political problems" the young activist argues.

In 2020 the Move Forward opposition party questioned royal spending paid by government departments, including nearly 3 billion baht (89,874,174 USD) from the Defense Ministry and Thai police for royal security, and 7 billion baht budgeted for royal development projects, as well as 38 planes and helicopters for the monarchy. Previously, on June 16, 2018, it was revealed that Thailand's Crown Property Bureau transferred its entire portfolio to the new King Maha Vajiralongkorn.

photo of graffiti of 112 crossed out on sidewalk

Protestors In Bangkok Call For Political Prisoner Release

Peerapon Boonyakiat/SOPA Images via ZUMA Wire

Freedom of speech at stake

"Article 112 shuts down all freedom of speech in this country", says Sirikan. "Even the political parties fear to touch the subject, so it blocks most things. This country cannot move anywhere if we still have this law."

The student activist herself was charged with lèse-majesté in September 2020, after simply citing a list of public documents that refer to royal family expenditure. Sirikan comes from a family that has faced the consequences of decades of political repression. Her grandfather, Tiang Sirikhan was a journalist and politician who openly protested against Thailand's involvement in World War II. He was accused of being a Communist and abducted in 1952. According to Sirikhan's family, he was killed by the state.

The new report was conducted by The International Federation for Human Rights (FIDH), Thai Lawyer for Human Rights (TLHR), and Internet Law Reform Dialogue (iLaw). It accuses Thai authorities of an increasingly broad interpretation of Article 112, to the point of "absurdity," including charges against people for criticizing the government's COVID-19 vaccine management, wearing crop tops, insulting the previous monarch, or quoting a United Nations statement about Article 112.

Activist in front of democracy monument in Thailand.

Shift to social media

While in the past the Article was only used against people who spoke about the royals, it's now being used as an alibi for more general political repression — which has also spurred more open campaigning to abolish it. Sirikan recounts recent cases of police charging people for spreading paint near the picture of the king during a protest, or even just for having a picture of the king as phone wallpaper.

The more than a century-old law is now largely playing out online, where much of today's protest takes place in Thailand. Sirikan says people are willing to go further on social media to expose information such as how the king intervenes in politics and the monarchy's accumulation of wealth, information the mainstream media rarely reports on them.

Not surprisingly, however, social media is heavily monitored and the military is involved in Intelligence operations and cyber attacks against human rights defenders and critics of any kind. In October 2020, Twitter took down 926 accounts, linked to the army and the government, which promoted themselves and attacked political opposition, and this June, Google removed two Maps with pictures, names, and addresses, of more than 400 people who were accused of insulting the Thai monarchy. "They are trying to control the internet as well," Sirikan says. "They are trying to censor every content that they find a threat".

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