Why we should think twice about putting psychiatric labels on politicians we don’t like

Barry_Goldwater_photo1962muskieThey’re crazy, right? Or maybe they have a “personality disorder.” Our current political season is raising the issue about how wise it is for commentators and the rest of us to put labels on politicians we don’t like  in terms of their mental health.

Susan Molchan, a psychiatrist in the Washington, D.C.-area, provides a thought-provoking commentary on this topic at Healthnewsreview.org, the excellent watchdog site for hype and misinformation about health-related matters. She argues that, barring a careful, expert, and actual diagnosis of a patient, it can be destructive to the public dialogue and stigmatizing to those with true mental health afflictions, for the media, in particular, to speculate about public figures’ mental disorder.

Many of these pieces, of course, focus on a polarizing current candidate−and she provides examples of his coverage with commentators’ theorizing. Others could be added, such as: this column in which its author analogizes her own negative health experiences on to the candidate; or this piece−which drew attention because its author also happens to be a psychiatrist.

But as Molchan points out:

As humans, when we see unusual or upsetting behavior, we want to understand it and explain it. When it’s something offensive to us, or is exhibited by someone we don’t like or don’t agree with, we may call that person names. …Given the stigma of mental illness, one variation of name-calling is to say they look  ‘manic,’ ‘bipolar’ have a ‘personality disorder,’ are ‘mentally unfit,’ ‘unstable,’ or ‘deranged.’

Candidates’ fitness for office, of course, must be a prime consideration of the electorate. But real, quality, thorough, and professional evaluations should be the touchstone here, not mere observational, reputational assault. As Molchan notes:

We can’t begin to discern a person’s psyche from a television screen. It’s unprofessional for psychologists or others in the mental health field to comment on a public figure’s “diagnosis” or supposed health problems, and journalists should keep this in mind if any “professionals” offer such opinions.

History tells us that some politicians whom many found mighty disagreeable were subject to negative “armchair diagnosis,” including GOP presidential nominee Barry Goldwater. After opponents assailed his extreme views in psychiatric terms, the American Psychiatric Association urged its members to avoid speculative comments about public figures’ mental health−a stance it has renewed and of which it has just reminded practitioners.  Lest memories run short, the tactic of questioning a politician’s mental fitness has hit both parties: consider the episodes involving Democratic candidates Edmund S. Muskie and Thomas Eagleton.

Meantime, some U.S. senators haven’t helped the messy mix of politics and professional diagnoses: Bill Frist, then the majority leader and a cardiologist, came to rue his weighing in on a notorious end-of-life case in Florida with a supposed, informed medical opinion made, based on a videotape; Tom Coburn, an ob-gyn, saw a videotape and weighed in with a medical view on the drugging of a soldier in a controversial military case out of Afghanistan.

I’ve written extensively about the critical importance of Americans actively engaging themselves in politics and policy, especially in the crucial area of our health care. Please vote. Please hold candidates’ feet to the fire about their detailed positions on improving the access, safety, quality, and affordability of medical care−and the array of public, social services necessary to maintain our collective and individual well-being. This kind of tough, determined effort can stamp out bad politicians on their merits, or lack thereof. But if we’re going to disagree about our politics, can we at least avoid putting psychiatric labels on politicians we don’t like?

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