The latest victims of a “hot mike,” that miraculous conduit of political candor, are Senator Susan Collins, the Republican from Maine, and her colleague Jack Reed, the Rhode Island Democrat. During a lull in an Appropriations subcommittee meeting on Tuesday, Collins and Reed kibbitzedabout the President’s state of mind, including his evident confusion about basic legislative procedure.
“I think he’s crazy,” Reed said, in a low voice.
“I’m worried,” Collins replied.
“I don’t say that lightly, as kind of, you know, ‘a goofy guy,’ ” Reed went on. “The, uh, this thing, you know, if we don’t get a budget deal—”
“I know,” Collins said.
“We’re going to be paralyzed, D.O.D.”— the Department of Defense— “everything is going to be paralyzed.”
Collins ventured that the President appears unfamiliar with the spending cap, passed in 2011, called the Budget Control Act. “I don’t even think he knows that there is a B.C.A,” she said.
When the audio of this exchange emerged, Collins’s office elaborated, to the Washington Post, that she is “worried” about “the elimination of transportation and housing programs in the President’s budget request.” A spokesman for Reed offered no apology, saying, “The Trump Administration is behaving erratically and irresponsibly.”
When Donald Trump was a candidate, his admirers explained his obsessions and his aggressions—about Megyn Kelly, Rosie O’Donnell, Hillary Clinton—as the excesses of a fierce competitor. When Trump was new to the White House, his friends defended his false claims—about “illegal votes,” the size of his Inauguration crowd, and the “highest” murder rate in decades—as bruised feelings from a tough campaign and settling pains in an unfamiliar environment.
But as Trump passed the six-month mark in office, facing historic unpopularity and a raft of investigations involving his campaign and his family, his comments and his political behavior have become only more bizarre, as if driven by the centrifugal force of his instincts. Among his recent fantasies, he asserted that the investigation into possible Russian interference in the 2016 election, headed by the special counsel Robert Mueller, was “not an investigation”; he ventured that Medicaid funding “actually goes up” under a Senate bill that would have cut it sharply; and he said that he had signed more bills “than any President, ever,” ignoring Bill Clinton, Jimmy Carter, Harry Truman, and F.D.R., all of whom, the Times noted, had signed more at this point in their terms. And finally, this week, Trump seemed to mistake a visit to a crowd of children and teen-agers for a political rally, reminiscing with an audience of Boy Scoutsabout an election-night event that probably happened past their bedtime: “Do you remember that incredible night with the maps, and the Republicans are red and the Democrats are blue, and that map was so red, it was unbelievable, and they didn’t know what to say?”
None of that was likely as disconcerting to Trump’s political allies, however, as his sudden, public turn against some of his most obedient servants. His primary target was Jeff Sessions, the campaign loyalist and Attorney General, whom he mocked and taunted for recusing himself from the Russia probe and opening the way for Mueller’s investigation. (Never mind that Sessions was ethically bound to recuse himself.) Trump has also shown signs of turning against his chief of staff, Reince Priebus, as he did with Sean Spicer, his former press secretary.
As a result of all this, the President’s behavior has inspired a renewed debate among mental-health professionals. For months, some psychologists and others have bridled against an ethical restriction that bars them from publicly opining on the mental health of Trump, or of any public figure whom they have not personally examined. After considering the matter, the American Psychiatric Association redoubled its commitment to the restriction, known as the Goldwater Rule, because psychiatrists, in 1964, had described the Presidential candidate Barry Goldwater as disturbed and he sued, successfully, for libel. This winter, the American Psychiatric Association expanded the rule to cover not only attempts at public diagnoses but also “professional opinions” about public figures.
But this month, another professional association made clear that it takes a different stance. In a memo on July 6th, the American Psychoanalytic Association said that members are “free to comment about political figures as individuals.” The group said that it “does not consider political commentary by its individual members an ethical matter.”
Lance Dodes, a retired assistant clinical professor of psychiatry at Harvard Medical School, told me, “For those of us who have been fighting for just such a public statement, this is wonderful news.” He went on, “There is no patient, therefore no issue of confidentiality, privacy, or consent. And, as with oncologists commenting on John McCain’s cancer, there is no ethical need to have examined a person to have a medical opinion.”
For some mental-health practitioners, the ethical debate is a distraction from a larger point. In a forthcoming book called “Twilight of American Sanity,” Allen Frances, a professor emeritus at Duke University School of Medicine*, argues that the more urgent concern is unravelling the national psyche that brought our politics to this moment. Frances told me, “We need to be looking in the mirror to see what’s wrong with us that would allow someone who is so unsuitable for the Presidency to rise to the highest and most dangerous office in the world. Trump’s psychology is far too obvious to be interesting. You don’t have to be a psychoanalyst to understand Trump. He’s the most transparent human being who ever lived. Giving it a name doesn’t explain it or change it.”
As Trump rages in the White House, the country has settled into a summer numbness. The protests have grown less frequent; the country has escaped to the beach; the latest cell-phone push notifications from news apps no longer produce a skip of the heart. Diagnosing that sense of permission and paralysis is an urgent problem, Frances said. “The instruments for dealing with Trump are political,” he added. “Psychological name-calling is an impotent avoidance of our responsibility as citizens, and it represents a failure to try to get insight into us, which is much more important.”