Mental Illnesses as Insults
Donald Trump's acceptance speech at the Republican National Convention seemed, by the end, too long and rather unfocused. The Atlantic, however, had a harsher assessment, calling it a "searing reminder that Trump is unwell". I will suppose that the writer (Tom Nichols) did not take himself merely to be hurling insults. But I will suppose also that the Atlantic has not given the former president a psychiatric examination. It appears to me that they are merely hurling insults after all. "Unwell" is a synonym in this case for "insane." They are saying that Trump is crazy. That there is some very primitive political commentary, slightly concealed as a health assessment.
Since 2016 at the latest, diagnosing Donald Trump (i.e. calling him nuts) has been a hobby and a pastime for otherwise reasonable-seeming commentators. Now "unwell" is pretty vague, or just means "batshit crazy." However, from early on in the Trump era, doctor/commentators such as David Brooks started getting much more technical in their diagnoses. "Trump continues to display the symptoms of narcissistic alexithymia, the inability to understand or describe the emotions in the self," wrote Brooks, obscurely. "Unable to know themselves, sufferers are unable to understand, relate or attach to others." That's bad, I think.
Pretty soon, the anti-Trump movement was actively recruiting "mental health professionals" to warn us all. But whatever may be going on with the professionals, mental health amateurs have made pseudo-diagnosis, and insults based on it, a major rhetorical trend. We are evidently in the midst of a severe outbreak of Narcissistic Personality Disorder, which is listed in the American Psychological Association's diagnostic manual (DSM-5) as 301.81. I wouldn't try to attack anyone in 2024 without lobbing 'narcissist!' at them, or just muttering '301.81' under my breath.
And though "301.81" is a very nice piece of ridicule, many other of the diagnostic categories of psychology can easily be repurposed as insults, and often are. It's probably not positive when I call you a "masochist" (302.83) or point out gently that you're "delusional" (297.1) or "catatonic" (293.89). Really, bubba, I think your problem is 312.9: Unspecified Disruptive, Impulse-Control, and Conduct Disorder. Possibly, we can medicate that, even if we can't characterize it clearly. The DSM is useful primarily as an anthology or dictionary of insults and is wielded that way all the time by psychologists and political consultants, among others.
Amazingly, many of the people who called Trump a narcissist started saying the same about Joe Biden, evidently hoping to shame and harass him out of the field, a project in which they perhaps succeeded. Many of the people who wanted Biden out called his continued hesitancy "narcissism." Why not? Biden is as big a narcissist as Trump!, declared the novelist Lionel Shriver in the Spectator. On X, the philosopher and legal scholar Brian Leiter called Biden a "pathetic narcissist" on the grounds that he'd stayed in the race. Leiter and the others do not believe themselves that they are merely hurling insults. They take themselves to be describing people scientifically or diagnosing them medically, I suppose. But they are not.
Indeed, Biden is all over the DSM these days, as plenty of people are also diagnosing him at a distance with dementia (331.83, perhaps).
As the discussions of Trump's and Biden's narcissism unfolded on X, "Philosopher Jersey Flight" tweeted that "Hitler was literally insane, his insanity being narcissism." No wonder there was a Holocaust! And it's interesting that Biden, Trump, and Hitler all congregate together under the flag of 301.81. That explains what Hitler and Biden have in common, and maybe even suggests treatment modalities, such as waterboarding. I'm sure Kamala Harris will be riding the narcissism train before the week is out.
True, it seems to be turning out that all political leaders suffer from narcissistic personality disorder (we sort of knew that, yes?), or perhaps it's turning out that 301.81 is so vague yet so pejorative that we can throw it randomly at everyone that we don't like, those Hitlers. If it were a concept, it would be a very useful concept. As it stands, in the DSM and in the public discourse, it is the merest synonym for 'asshole,' with just that tang of pseudoscience that makes it stick among the educated-yet-spiritually-empty.
Now, the claim that Trump or Biden is a narcissist, i.e. an asshole, is not relevant to whether any particular thing they say is true or false. It doesn't suggest any particular policy or course of action, though it tosses them into the DSM and bundles them up with Hitler. As it stands, it doesn't distinguish Trump from Biden, or either of them from Hitler, Genghis Khan, Nature Boy Ric Flair, the Kardashians, James Madison, Lebron James, or, really, anyone else.
Even the person who wrote the DSM-5 has said that that using its categories to diagnose public figures is "bullshit". And it strikes me, as it ought to strike the Atlantic, that hurling psychological diagnoses as insults, or disqualifying people on the grounds that they are "unwell," recapitulates and strengthens the stigma surrounding mental illness.
Follow on X: @crispinsartwell.