Dr. John Gartner: “We Have a Duty to Warn the World About Donald Trump”

Mar 22, 2017

Everywhere you go, regardless of who you talk to, President Donald Trump and his cabinet come up. Not only does news related to the Trump Administration — whether delivered personally from him or not — clutter news feeds and social media timelines, it also might be damaging to our health.

I’ve been interested in this because my mother had significant mental health issues that were undiagnosed and, for much of her life, untreated. My young life was changed in ways big and small by her mental health issues. She could be pleasant, funny and entertaining on her best days. But on her worst days, she was a bully who could spew hateful, damaging words that were usually the precursor for the physical breaching of boundaries.

So I was intrigued by the conversations around President Trump’s mental health that began circulating recently. I started reading about the ongoing conversation among psychiatrists who have been debating the ethical appropriateness of diagnosing the President without having personally conducted an interview to evaluate his mental health, citing the Goldwater Rule.

Dr. John Gartner, who works both in D.C. and in New York, started a petition that now has more than 38,000 signatures. He has been practicing psychiatry for 30 years. I talked to him to get a sense of why he felt it was important to go against the conservative members of his organization and diagnose President Trump as a malignant narcissist, as well as what actions he wants to take next.

Tell me about your petition and how it came to be.

The Diagnostic and Statistical Manual of Mental Disorders is very clear about having a clear behavioral diagnostic material for every disorder. Things like frequently lying — the level and massive amount of lying from President Trump is unprecedented. And the DSM criteria is very objective and cadent. You don’t need to have an interview to know if someone has frequently lied or has violated the rights of others.

The psychiatric interview is hardly the gold standard, by the way. If you have massive amounts of information about a person’s behavior, that can be more accurate. And we have that. If the question is whether we can form a diagnosis from that information, I think it’s clear that we can.

In our field, we have a duty to warn. If a patient says they might harm someone, you’re mandated by law to violate constitutionality to warn that person. We’re talking about a need to warn all people that this person is a threat to world peace because of his psychiatric disorder because of our training and experience. For us to see the danger would be like being on a train and seeing someone with a bomb and not saying anything. But as professionals, we’re being told (by other psychiatrists) if we see something, say nothing. I don’t want to have to answer my grandchildren who ask me what I did to respond to the war with China.

What responses have you gotten?

We’re getting a combination of responses. Letters of gratitude. People saying, “Thank you for doing this.” Our Facebook Group, Duty to Warn has more than 650 people in it. The conservative element of the psychological community has hunkered down and pushed back, with letters going back and forth in the New York Times. I debated someone on NPR.

There are the keepers of the orthodoxy and then there are the abusive, crazy, angry voicemails from ordinary Trump supporters. I get threatening messages and people putting negative reviews online about my practice. A kind of “We’ll get you” kind of thing, but that’s happening nationally, that kind of intimidation and virtual lynch mob against anyone who tries to go against Trump.

Basically, I posted it on some mental health groups on Facebook. Half of them deleted it because they thought it wasn’t ethical. In a group of 50/60 people, I’ve only had one really disagree with me. The question of whether we’re allowed to say something about this doesn’t mean they don’t feel the same way. This is really the predominant impression of the people in our field, even the people who think you shouldn’t say anything.

What do you think your chances of success are?

I’m well aware that I’m devoting my life to a fairly hopeless cause. I think it just goes back to my Jewish roots. Never again. We must speak out. We must be a witness to the truth. Whether that will change policy, I’m not that optimistic.

Is this Congress going to impeach him? I’m not optimistic about that either. We have been trying to actively make contact with the Congress — there is a third measure, including (House Oversight Committee Chairman) Jason Chaffetz, saying the President should be required to take a mental health test.

I was gratified to see that a member of Congress was citing our petition in the need for a law requiring the President to have a mental health exam. Ted Lieu has essentially said, “I’m no psychiatrist, I can’t know for sure, but he seems to be acting crazy to me.” Al Franken has said that many of his Republican/Senatorial colleagues have privately expressed concerns about Trump’s mental health.

We are all exposed to this behavior. Are there ways that we can protect ourselves emotionally/mentally so that we mitigate the impact?

The most effective coping mechanism is meditation. I use mindfulness meditation in my practice, I’ve been practicing for 30 years. It has been the only thing keeping me sane.

What is your next course of action, if the debate continues?

We don’t really expect that he’ll be removed by his cabinet under the 25th amendment. We’ve formed an organization called Duty to Warn, a technical term from psychiatry. (The term means that professional therapists have a duty to warn the authorities or others if they have client who is a danger to herself or others.) We have a duty to warn the public about the danger that Donald Trump’s mental health poses to the world.

We don’t have the answer. We do feel a professional obligation to be witnesses. The person who is in control is out of control. Our duty to warn is more important than the Goldwater Rule. Our job is to make people aware. Where they go with it, we don’t have control over.