The Conundrum of Donald Trump, Mental Illness and His Racism

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I’ve heard this before. “I don’t like it when people see 45’s intolerance and call him ‘mentally ill’.” And while I fully understand the sentiment and even why it can be quite problematic to do that, I don’t think the conundrum of Donald Trump, mental illness and his racism is touched upon well in tweets like this one. In fact, I would argue that such remarks may entirely miss the mark (the understandable limitations of 280 characters notwithstanding). There are some huge issues in the way we discuss mental illness (and racism), and this tweet highlights many of them…but not in the way I think he and others who say this intended.

Most profoundly, comments like these always seem to illuminate the shortcomings of this discussion, including some very problematic assumptions and glaring areas unconsidered. One of the most problematic assumptions of all underlying and inherent in the “some of my best friends are mentally ill” statements must be addressed with this one:

MENTAL ILLNESS IS NOT A SINGULAR UNIFORM MONOLITHIC CONDITION.

The 5th edition Diagnostic and Statistical Manual of Mental Disorders (DSM), the diagnostic tool used by the American Psychiatric Association, has nearly 300 mental illnesses/psychiatric disorders within it. That’s 300 mental illnesses, each with their own symptoms and characteristics. And though each of those nearly 300 mental illnesses have a set of characteristics and features used for identification, not every single person exhibits the full comprehensive list of characteristics for the mental disorder that they have. Plus, most, if not every single one of those approximately 300 mental illnesses also range in severity of symptoms.

So, it is critical that while we fight to make strides in not stigmatizing or demonizing those with mental illness, we also don’t create a fictional narrative either. There are millions of non-violent (and not racist) people with mental illness in America.

Yes, you know them.

I know them.

Many of us ARE them.

But that doesn’t change the very real and science reality that there are mental illnesses for which behaviors such as severe aggression is a characteristic of the specific psychiatric disorder for some individuals. I’ve worked extensively with this population. They are human. They have rights. They have lives.

And that’s just one subset of folks with mental illness.

This is not by any means a totally foreign notion to the American public. It’s a hallmark of our national discourse on gun control. Who should be able to own a gun and who shouldn’t. How to, the necessity to, restrict the purchase of guns to not include those unable to be trusted with gun possession due to their psychiatric condition or instability. And while the claim is debated that on one hand, most recent mass shootings have not been carried out by a person diagnosed as mentally ill, the flip side of the data coin tells us that the risk of violence is higher with certain specific mental illness diagnoses and of the mass shootings carried out since the 1900s, more than half of them were carried out by those “diagnosed with a mental disorder or with demonstrable signs of serious mental illness prior to the attack.”

But of course, we know that that discussion of mental illness and gun control isn’t even as simple as mass shooting data. Gun violence takes place in more contexts than that. And this nation has a jones for bestowing mental illness upon White murderers like a knightship that comes with a get-out-of-jail-free card (get-out-of-just-sentencing card?), all while ignoring the psychiatric effects of violence, economic trauma, institutional racism, and racialized state-sanctioned and executed abuse on the people of Black and brown and poor communities. Black people don’t get public speculations of bipolar or post-traumatic stress disorder when they commit acts of violence; instead, they’re classified as just anotha n*gga with no self worth, and therefore the community unworthy of crime-adjacent mental health discussions.

All of that being said, everyone with mental illness is not necessarily like the oft cited familiar friends or family members (or self), our loved ones that do what they can to struggle from day to day through the symptomatic challenges associated with their anxiety or other mental illness, but doesn’t pose a danger to anyone.

There are mental illness conditions with characteristics that are prime settings for behavior that harms others in countless ways. For instance, a pathological inability to feel empathy can be a characteristic associated with certain psychiatric conditions. In its less severe state, this particular challenge may just result in socially inappropriate responses to others and a difficulty connecting with others or maintaining relationships.

That same symptom in its severe state? Especially if paired with other comorbid mental illnesses like schizophrenia? THAT could contribute to the neglect of a child or the emotional, psychological and/or physical destruction of another.

And I get it. The very reason we struggle with stigmatization is because of this uninformed societal mischaracterization of all people with mental illness as being dangerous.

They’re not. That’s wrong.

But the narrative that says there aren’t people with mental illness doing things that harm others as an extension or connected behavior or symptom of their mental illness is also wrong. It’s false. It just is.

There is great variance in mental illness, and we have to get to the place where our discussions and policy reflect that variance at all times.

And just like there are millions of people diagnosed and undiagnosed with depression living and going about their everyday lives, there are undiagnosed people with antisocial personality disorder and other mental illnesses with psychopathological or psychotic or otherwise toxic characteristics living amongst us.

https://www.nhs.uk/conditions/antisocial-personality-disorder/

And that shouldn’t be surprising to anyone living in this society that historically and presently rewards cruelty, especially if the one engaging in that cruel behavior is some slot machine combination of White, wealthy or male. (I hear in some situational casinos, if you’re lucky, you can get “White” in your reel and nothing else and still win the cruel-but-rewarded jackpot. Not always, but the odds are high.)

Does Donald Trump genuinely display the characteristics of a mental illness in the DSM? I believe one can certainly argue that he does. In fact, 70 psychologists, psychiatrists and mental health professionals wrote a letter stating exactly that.

In addition to the symptoms observed by those mental health professionals, many of Donald Trump’s most alarming behaviors are exacted through cruel, racist-related words and actions. I suspect that’s what makes some people prickle when others look at his xenophobic and racialized sadism and call him mentally ill. And I understand why. Can mental illness make you racist? Of course not.

But here’s the real tea in the form of a question most don’t want to ask:

IS RACISM A FORM OF MENTAL ILLNESS?

Well, let’s see…

Racism is typically characterized by sporadic or relentless pathological attempts at control and harm of an individual or group based in thoughts that are delusional and a chronic resistance to reality.

Racism is a state of mental (mal)functioning that often causes the racist to engage in conscious and unconscious behaviors that clearly result in their own harm in their effort to bring adverse or destructive events upon the group or group member that the racist perseverates on.

Racism is a state of mental (mal)functioning that can appear to impair other intellectual functions of the mind, including its ability to differentiate what is real and what is not, resulting in greater susceptibility to irrational thoughts and false information not based in reality.

As a matter of fact, in 1944 when the Swedish economist and sociologist, Gunnar Myrdal, was invited to America to study “the Negro problem” in the south, he came and immersed himself in the place, the culture, walked upon this nation’s Black blood-soaked ground, saw Jim Crow’s white feathers flying high and after five years of study, came to one conclusion, the only deductive conclusion: “that they [White people] are very confused in their mind.” Myrdal declared that the White folks that brought him there were right about one thing — America absolutely has a problem, but that they got the color wrong; there was no Black problem. There was a White one. An entire nation of [White] people chronically and violently afflicted with a perpetual state of obsession and severe delusion, possessing a full-out psychological departure from reality, even in their intellections about their own identity and behavior, when it came to Black people and race.

Myrdal published this national study in 1944 in an exhaustive examination of the historical, psychological, legal, anthropological, economic and sociological meaning and function of White and Black race titled, An American Dilemma.

To watch a documentary on Gunnar Myrdal, click here.

I know some of y’all are saying, Awww, but that was 1944. I want you to know that the conditions he observed have not changed. And if you watch the documentary I linked above, you’ll hear respected academics of today say Myrdal’s study is all still reflective of America, the beautiful.

But if you need a more contemporary voice, Professor of psychiatry, Alvin F Poussaint, of Harvard University wrote in an article for the Western Journal of Medicine in the year of our Lord 2002, “To continue perceiving extreme racism as normative and not pathologic is to lend it legitimacy.”

Isn’t. That. Something.

And in this world of mass shootings committed regularly by White Supremacist terrorists, in this world of school-to-prison pipelines and White Supremacy propagandized curriculums, in this world of Hispanic children in cages, dead sojourning children and families permanently separated, in this world of underserved Native reservations and pernicious pipelines in places like Fort Peck and poisoned drinking water in Flint, in this world of gentrification (colonization), tiki torches and casual racism protected by White practice if not company policy, if considering this world, I think you should see what else Dr. Poussaint had to say in that article on White racism:

“The American Psychiatric Association has never officially recognized extreme racism (as opposed to ordinary prejudice) as a mental health problem…”

“…a group of Black psychiatrists sought to have extreme bigotry classified as a mental disorder. The association’s officials rejected the recommendation, arguing that because so many Americans are racist, even extreme racism in this country is normative — a cultural problem rather than an indication of psychopathology… To continue perceiving extreme racism as normative and not pathologic is to lend it legitimacy. Clearly, anyone who scapegoats a whole group of people and seeks to eliminate them to resolve his or her internal conflicts meets criteria for a delusional disorder, a major psychiatric illness.

More recently, Sullaway and Dunbar used a prejudice rating scale to assess and describe levels of prejudice. 3 They found associations between highly prejudiced people and other indicators of psychopathology. The subtype at the extreme end of their scale is a paranoid/delusional prejudice disorder.”

It is time for the American Psychiatric Association to designate extreme racism as a mental health problem by recognizing it as a delusional psychotic symptom. Persons afflicted with such psychopathology represent an immediate danger to themselves and others. Clinicians need guidelines for recognizing delusional racism in all its forms so that they can provide appropriate treatment. Otherwise, extreme delusional racists will continue to fall through the cracks of the mental health system, and we can expect more of them to explode and act out their deadly delusions.”

Now, to be thorough, the former Cosby Show consultant is not without criticism for highly problematic actions pertaining to his relationship with serial rapist and show creator, Bill Cosby. Some actions that were, ironically, a reflection of Dr. Poussaint’s own internalized anti-Blackness and classism. (Clearly, no one is safe with the infectious disease of White Supremacy about.) Nevertheless, in lieu of Dr. Poussaint’s reference to objective historical and contemporary facts in the above peer-reviewed publication (and its presence in an actual peer-reviewed publication), his reference to the efforts and work of other psychiatrists that have also considered this question, and in lieu of him not being the first, only or last to have critically analyzed the behaviors associated with White racism through a psychiatric lens and arrived at the same professional opinion, the information he presents is not null and void. The argument is sound.

Debatable? Sure. But still sound.

While many express grave concern that such arguments reduce systemic issues of race to that of individual pathology, I strongly believe that we humans can possess the ability to hold all of these truths to be self-evident:

  • that racism is not within the realm of healthy or normative psychological functioning, requiring individual as well as wide-scale social deconditioning and preventative measures,…
  • that these words may be profoundly accurate -“to continue perceiving extreme racism as normative and not pathologic is to lend it legitimacy,” — and if accurate, legitimacy a wholly intolerable concession,…
  • AND that the legal system must address discriminatory and violent criminal racist behavior with consistent consequences that protect the public as well as serve as aversive, effective deterrents,…
  • AND that large scale measures must be taken to dismantle the racially oppressive systems created by White racism (and capitalism) that are exacted through individuals in addition to a deconstructing of the social customs and racist power norms that aid and abed those systems, diminish our health and deprive us life, liberty and the pursuit of happiness,…
  • AND that policy in every area of business, legislation and public life must uphold and enforce equity and justice.

Complicated problems rarely ever have a simple single-pronged solution.

(Note: Though these investigations and professional conclusions were specifically about racism and mental illness, as is this article, there definitely may be other isms for which these conclusions could hold true, at least in part.)

The question explored here may not be popular or even significantly present in everyday discourse. Nevertheless, the literature and the objective evaluations on the matter are worth considering and integrating into how we interrogate racism in general, Donald Trump specifically and his mental health.

The term or identifier “mental illness” should never be trivialized or thrown around carelessly. Whether the severity of the diagnosis is mild or severe. Whether it’s the kind of mental illness more folks feel comfortable acknowledging or the kind they’d rather forget exists.

Regardless, it is an objective fact that mental illness or psychiatric disorders encompass an incredibly vast array of symptoms and behaviors. From one person’s depression that makes it hard for them to get out of bed or feel joy to another’s pica, a psychiatric disorder classified in the DSM that I’ve seen firsthand in which individuals eat/swallow non-nutritive substances like batteries and cigarette butts. Anxiety disorders. Bipolar disorder. The earlier mentioned Antisocial Personality Disorder, commonly referred to as psychopathy. Pyromania. Sexual Sadism Disorder. All of it. Hanging out together in the American Psychiatric Association’s diagnostic manual.

And if White Supremacy didn’t rule the world like it does, and if White folks weren’t the gatekeepers of science in America, the DSM would likely include racism as a mental illness as well. The qualifying symptoms, the behaviors, are there.

So what’s wrong with saying Donald Trump is mentally ill? To a large degree, nothing at all…that is, if the issue you have with the statement is accuracy. His racism, how he acts upon his racism and so much more thoroughly suggest it.

I mean, if the symptoms fit, then — theoretically — he can wear it.

From the opening tweet’s, “45’s hate is deliberate. Don’t blame mental illness. It’s all him”? Yes, it’s deliberate. Yes, some (many?) of his actions may be directly symptomatic of or indirectly related to mental illness. Yes, emphatically yes, it’s all him. Just be careful to remember that when it comes to mental illness and associated behaviors that place the lives of others on the line, mental illness in and of itself does not provide absolution from all accountability and consequences…or at least it shouldn’t.

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For anyone that’s going through something and needs to talk to somebody, there’s no shame in it. Ever. You can call a hotline or 911 to get help: This hotline is available even via text message to anyone experiencing mental health difficulties or an emotional crisis. Highly trained counselors offer support and guidance to calm you down and make sure you are safe.

Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1–800–662-HELP (4357)

Hang in there. Keep fighting. Your life matters.

If no one has told you that they love you today, let me be the one: I love you.

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