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Opinion We must not politicize psychiatry, no matter what Trump tweets

Peter McKnight is an adjunct professor in the school of criminology at Simon Fraser University.

I’ve seemingly come down with a bad case of narcissistic personality disorder. And anti-social personality disorder. And just about every other disorder detailed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Indeed, just thumb through the manual, stop at any random point and see how you fare against the criteria for whatever disorder you land on. Chances are, you’ll find you match at least some of the criteria – unless you’re a saint, in which case you probably qualify as psychotic, given that many saints experience visions, or, as a psychiatrist might say, hallucinations.

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This reveals the silliness of conservative lawyer George Conway posting snippets from the DSM-5 in an effort to impugn the mental fitness of U.S. President Donald Trump. And, as if to prove that Mr. Trump isn’t the only one capable of brewing up a Twitter storm, Mr. Conway issued a flurry of tweets suggesting the President suffers from both narcissistic and anti-social personality disorders, the very maladies that are bedevilling me. And you.

When questions about Mr. Trump’s mental fitness first arose, many psychiatrists wisely shot down such armchair analyses, stressing that you can’t diagnose someone without examining him or her. That calmed things down for a spell, but since no controversy ever stays buried in the Potomac, Mr. Conway’s febrile Twitter feed has now managed to resurrect the debate. In response, I could repeat the folly of diagnosing someone from across the room. But there’s little point in beating that dead horse, given that it has evidently run its course.

Besides, there’s a much more important aspect of the controversy, and it concerns an unholy alliance – collusion, if you will – between psychiatry and politics. I use the word “collusion” advisedly, since we can best witness this all-too-close relationship by venturing to Mr. Trump’s putative favourite country, Russia – or more accurately, the Soviet Union.

In the 1960s, Andrei Snezhnevsky, the director of the Institute of Psychiatry of the USSR Academy of Medical Sciences, “discovered” a new, pernicious mental illness – sluggish schizophrenia.

Unlike other forms of schizophrenia, sluggish schizophrenia had no symptoms, which made it a terribly easy label to apply to political dissidents. Indeed, thousands of dissidents were diagnosed with the disease and spent decades languishing in Soviet psychiatric gulags. And if they were lucky enough to be released, they lived the rest of their lives deprived of virtually all civil rights. In addition to inventing sluggish schizophrenia, Dr. Snezhnevsky personally diagnosed many of the most prominent dissidents with the disease.

Clearly, he was not acting in a medical role, but rather was using – abusing – psychiatry to further his political interests. And for his efforts, he received about a million awards from his Soviet masters. Is this really the man Trump critics want to follow?

Americans do not, however, need to peer overseas to see the danger of the alliance between psychiatry and politics, when evidence is in their own backyard. Indeed, the misuse of psychiatry to achieve political ends has a long and ugly history in the United States.

Consider drapetomania, the 19th-century mental illness that afflicted only black people – and for an obvious reason. Unlike sluggish schizophrenia, drapetomania had a single symptom – the desire to flee from slavery. And speaking of schizophrenia, in The Protest Psychosis, Vanderbilt University psychiatrist Jonathan Metzl documented how at least one hospital in the 1960s diagnosed black Americans with schizophrenia thanks to their agitation for civil rights.

Again, is this really the model Trump detractors want to follow? As history attests, psychiatry is easily infected with politics, and once so infected, it can be, and is, used by those in power to advance virtually any political program. Trump detractors might think they’re on to something by applying psychiatric labels to the President, but since what goes around comes around, let me ask them one final question:

Given Mr. Trump’s willingness to use anything, including the military and the police, to advance his own interests, do you really want to hand him an excuse to use the awesome power of politicized psychiatry against his opponents as well?

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