Rethinking the ‘Goldwater
Rule’
By
Maybe it’s time America’s psychiatrists reconsider their
Goldwater Rule.
The Goldwater Rule simply states that
psychiatrists shouldn’t diagnose the mental health of a public figure unless
they’ve personally examined the person.
Naturally, if any public figures have sought mental health treatment, their doctors would be bound by confidentiality agreements.
Naturally, if any public figures have sought mental health treatment, their doctors would be bound by confidentiality agreements.
In short, at present, if a public figure doesn’t wish to be
diagnosed with a mental illness, or if they don’t want the diagnosis made
public, then it will remain a secret.
In most cases, this is a good rule. After all, mental illness is
still stigmatized.
One of our most successful presidents, Abraham Lincoln, famously
suffered from severe depression, but he still did his job well. We wouldn’t
want a modern, would-be Lincoln to face discrimination simply because his or
her depression became public.
But there’s a circumstance in which I believe the Goldwater Rule
is harmful.
There are some mental illnesses that are incurable and rarely
treatable that would also make a person unqualified to be president. Imagine a
sociopath, or someone with narcissistic personality disorder, for example.
People with narcissistic personality disorder rarely seek treatment, according to University of Kentucky psychologists Cristina Crego and Thomas Widiger.
If they do, it’s often because someone else forced them to do
so, like a spouse who threatened to leave unless they went to therapy. But even
if they show up regularly for their appointments, they may struggle to do the
soul searching required in therapy.
The most hopeful response I’ve ever heard from a mental health
professional about the prognosis of someone with narcissistic personality
disorder is that maybe, with a lot of time and hard work in therapy, they might
get a little bit better.
Narcissistic personality disorder is seriously debilitating, but
often the person suffering from it believes that they’re fine and everyone else
around them has the problem.
Imagine someone in the Oval Office whose biggest need every day
is to feel important and loved by everyone around them, and who responds with
rage when they perceive any sort of criticism.
This is a person who cannot do the business of the country or
put the needs of the country first because his or her personal needs due to the
disorder will rule their lives.
Given that there will be an entire opposing political party who
does not like them, not to mention entire shows on television like Saturday
Night Live devoted to making fun of them, no president will be loved by all.
Every president must deal with criticism every single day.
What happens if the president feels slighted by a foreign
leader? He or she could respond with sanctions, war, or even nukes.
Narcissists often don’t think the rules apply to them because
they are special. They should be able to do what they want to get what they
want. The U.S. president isn’t above the law, and it would be dangerous to
elect someone who believes he or she is.
Given that such a person is never, ever likely to seek
treatment, nor are they likely to allow a psychiatrist to make an assessment of
their mental health public, that means that — should such a person be elected —
there’s no way for psychiatrists to warn the public.
If the Goldwater Rule were rescinded, there’s certainly a danger
that psychiatrists would publicly misdiagnose a public figure, or public
figures with treatable mental illness would face unfair scrutiny.
Yet we must find a way to close the current loophole, which may protect someone mentally unfit for office from expert scrutiny.
OtherWords columnist Jill
Richardson is the author of Recipe for America: Why Our Food System Is Broken
and What We Can Do to Fix It. Distributed by OtherWords.org.