The norm in mental health practice has wisely been to stay out of politics for the most part, except when it comes to mental health advocacy.
It would obviously be problematic if individual mental health experts (such as psychiatrists, psychologists, social workers, nurses, etc.) or groups representing professionals (such as specialist associations, editorial boards from journals, etc.) were to endorse or criticize political figures, with a goal to influence elections.
But sometimes there needs to be an exception to this neutral policy.
Mental health professionals have a great deal of experience recognizing and dealing with individuals who have behavioural and relational problems such as narcissistic and antisocial personality. And the most valuable experience mental health professionals bring to this issue is work with patients whose partner, spouse, close friend, parent, boss, or other family member has narcissistic or antisocial traits.
If a patient is in a close relationship with someone having narcissistic or antisocial traits, there can be many reasons why the patient has a hard time escaping the relationship. The relationship may be all they have known for many years. The relationship may initially have been exciting, passionate, and positive, perhaps an escape from some other adversity, before the narcissistic and antisocial problems showed themselves. Other people in the patient's life, including important figures such as family or church leaders, may insist or encourage that they stay. The patient may not recognize or frame the problems in the relationship as abuse, and may instead normalize the behaviours they suffer. Others may be trapped in relationships of this type for economic reasons. They may fear leaving, due to concerns not only about risk of violence, but also of social or economic isolation. Others may experience periods of being cared for at times by their narcissistic or antisocial partner, and/or cared for by the social network which supports this relationship, despite the overall toxicity of the situation.
These factors are similar to the cognitive biases I have described in other posts -- interpersonal or group affiliations can be so strong that they keep people locked into certain choices or behaviours due to group or "status quo" loyalty, even when the experiences they are having are very harmful to themselves and others. In such entrenched situations, people will selectively attend to data that supports the status quo, and reflexively reject information that encourages change, even if this information has a very strong and compelling level of evidence.
At present, there are important choices in global elections coming up, and a shocking proportion of people appear willing to vote for a person whose behaviour is laden with very serious and dangerous problems. Not only are there severe narcissistic traits and shocking mean-spiritedness evident on an almost daily basis for many years, there are frank antisocial traits including criminal behaviour, as well as other very troubling features including an obvious lack of intellectual skills, fund of knowledge, or intellectual curiosity. Furthermore, there will be a team of other people supporting or working with this person who share similar traits, behaviours, and attitudes, in an ever more exaggerated way compared to 5-10 years ago. It is especially shocking that certain groups whose personal and group culture is devoted to devout faith, moral purity, law & order, and personal freedom, would double down in their support for this person whose behaviour is in consistent and extreme contradiction to these values.
Of course, it is true that unless a detailed assessment were to be done, we could not have the confidence to make a psychiatric diagnosis. But in the realm of narcissism and antisocial personality, most of the actual evidence for such diagnoses comes from collateral information of the patient's behaviour. In an actual interview, many people with problems of this type can present themselves in a seemingly normal way (though in this particular case I think there would be many simple ways in an interview to demonstrate some of the problems unequivocally, especially the intellectual weaknesses).
In any case, this situation reminds me of trying to help a patient who is in a dangerously abusive relationship with a spouse, yet who insists on staying and who might get angry or upset at the suggestion that they could think about leaving.
The role of a mental health professional would involve compassionate exploration of the history, help with treating symptoms of pain or suffering, but also there would need to be movement towards encouraging change or leaving the relationship. Here, a motivational interviewing framework would be needed, since simply encouraging or pushing for change could be very counterproductive if the person does not desire this. Other ideas for helping include tactics similar to what is described in David McRaney's book "How Minds Change." (see my post about this book).
Another role of mental health professionals could be to discuss the issue of narcissism, antisocial behaviour, and abusive relationships in a public setting, as an educational endeavour to help people recognize and avoid such relationships in the first place, and to be in a position to help others.
I have felt that the mental health community has not spoken out appropriately about the current public figure issue I have been alluding to. I understand the principles behind the reserve, i.e. staying neutral in politics, but this is such an intensely important issue impacting individual and public well-being that something needs to be said about it. Also, professionals, professional organizations, and editorial boards from journals need not spell out specific opinions about a particular case or a particular person, rather they could simply speak out about recognizing narcissism, antisocial behaviour, entrenched attachment to abusive relationships, the extreme dangers to well-being involved with such situations, the psychological factors preventing change, and things we can all do about it, without spelling out any particular individuals.
Links:
Garth Kroeker: How Minds Change by David McRaney: a book review and discussion
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