Putting Trump on the Couch

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In 1973, the American Psychiatric Association established the so-called Goldwater Rule as a response to the many mental-health professionals who had ventured glib and florid diagnoses of Senator Barry Goldwater during his 1964 presidential campaign. “I believe Goldwater has the same pathological makeup as Hitler, Castro, Stalin, and other known schizophrenic leaders” was a representative comment; many other psychiatrists and psychologists deemed him schizophrenic, a “megalomaniac,” and “chronically psychotic.” In the four decades between its enshrining and the 2016 election, the Goldwater Rule—which prohibits psychiatrists from issuing diagnoses of public figures they haven’t seen as patients—was mostly honored.

But from the earliest moments of Donald Trump’s campaign, his behavior, falling far outside the boundaries of conventional candidate comportment, raised the question of whether he could be adequately assessed in purely political terms. Where did politics end and psychology—or psychopathology—begin? Thus the Trump years have inevitably given rise to the routine flouting of the Goldwater Rule, most notably in a collection of writings assembled by the former Yale psychiatrist Bandy Lee, The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President. (Lee subsequently got fired from Yale for publicly arguing that Alan Dershowitz was suffering from a “shared psychosis” with Trump.)

Now, with Trump the Republican 2024 front-runner—his accumulating indictments notwithstanding—the psychiatrist Peter D. Kramer seems to have successfully engineered an end run around the Goldwater Rule: In his interesting and challenging new novel, Death of the Great Man, Kramer takes on some of the relevant psychological issues of the Trump era via fiction.