Tag Archives: mental illness

Trump’s Troubled Mental State

Psychiatrists warn of president’s alarming behavior

Association sacks Goldwater Gag Rule preventing analysis of POTUS

by SHARON BEGLEY @sxbegle

A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures — even the president.

The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior. It will likely make many of its members feel more comfortable speaking openly about President Trump’s mental health.

The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. “We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

An increasing number of psychologists and psychiatrists have denounced the restriction as a “gag rule” and flouted it, with some arguing they have a “duty to warn” the public about what they see as Trump’s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead.

Reporters, pundits, and government officials “have been stumbling around trying to explain Trump’s unusual behavior,” from his seemingly compulsive tweeting to his grandiosity, said Dr. Leonard Glass, a psychiatrist at Harvard Medical School. The rule against psychiatrists offering their analysis of the emotions, thought patterns, and beliefs underlying such behaviors, Glass said, robs the public “of our professional judgment and prevents us from communicating our understanding” of the president’s mental state.

Last week, in an essay in Psychiatric Times, Glass called the prohibition on such communication “an unacceptable infringement on my right and duty” to discuss issues “where the perspective of psychiatrists could be very relevant and enlightening.” He ended the essay by announcing his resignation from the American Psychiatric Association, which adopted the rule in 1973. He had been a member for 41 years.

Called the “Goldwater rule,” the prohibition on offering opinions about the mental state of public figures was adopted after some psychiatrists answered a 1964 survey on whether Sen. Barry Goldwater, the Republican presidential candidate that year, was mentally fit for the Oval Office. The rule states that it is unethical to offer a professional opinion about a public figure’s mental health, including the presence or absence of a disorder, without that person’s consent and without doing a standard examination. In March, the psychiatric association reaffirmed the rule.

The group acted despite growing criticism that the Goldwater rule is outdated and even unethical for preventing psychiatrists from pointing out behaviors that raise questions about a government official’s mental state. No other medical specialty has such a rule; cardiologists are not prohibited from offering their views of an official’s fainting spell, for instance, as long as they make clear that they have not examined the person.

Although opposition to the Goldwater rule has existed for years, it intensified with Trump’s candidacy and then election. In October, a book titled “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” will be published.

“When the book comes out, there will be renewed furor about the Goldwater rule, since it is precisely about what is wrong with him,” said psychiatrist Dr. Lance Dodes, a retired professor at Harvard Medical School who is now in private practice in Los Angeles.

A number of psychologists have spoken to reporters about what Trump’s statements and actions might reveal about his emotional and cognitive state. Although the American Psychological Association “prefers” that its members not offer opinions on the psychology of someone they have not examined, it does not have a Goldwater rule and is not considering implementing one, an official told STAT.

The psychoanalytic association went further. In its July 6 email, it explicitly stated for the first time that the organization does not subscribe to the rule. That position had been implicit for years, but the association’s “leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association,” said one psychoanalytic association member who asked not to be publicly identified criticizing the other group.

One stated rationale for the Goldwater rule is that psychiatrists need to examine patients in order to properly evaluate them. In fact, for decades the State Department and other federal agencies have asked psychiatrists to offer their views on the psychological state of foreign leaders, Glass pointed out, evidence that government officials believe it is possible to make informed inferences about mental states based on public behavior and speech.

“In the case of Donald Trump, there is an extraordinary abundance of speech and behavior on which one could form a judgment,” Glass said. “It’s not definitive, it’s an informed hypothesis, and one we should be able to offer rather than the stunning silence demanded by the Goldwater rule.”

The Goldwater rule has long been odd in that violating it carries no penalties. In principle the psychiatric association could file a complaint with a member’s state medical board. That has apparently never happened. Nor has the association ejected a member for violating the Goldwater rule. That is something it, as a private association, would be legally permitted to do.

A state agency, however, is subject to the U.S. Constitution, civil liberties experts say, and penalizing psychiatrists for speaking out would likely be a violation of their First Amendment rights. §

Sharon Begley, senior science writer, covers genetics, cancer, neuroscience, and other fields of basic biomedical research. This article is posted with the permission of STAT, where it originally appeared.

A happy death?

Mental illness and threats of suicide

CITY LIFE.KEVIN LAWRENCEBy Stacey Warde

“If one of these dogs dies I’m going to make an art project out of this ceiling by blowing my fucking brains out,” Kevin said.

He waved his hand with a flourish, like a painter, above and around the living room where he kept a double-sized mattress on the floor behind a couch facing a big flat screen on the wall where he watched the news and endless rounds of music documentaries and concerts.

He slept on the floor, he said, because it was easier for him, the dogs, and the women who ventured to sleep with him, to crash there rather than climb into bed in another room. And the big screen was always turned on.

We had just finished smoking a joint in this living room in a house he rented in Cayucos, and began trimming some of the marijuana he hauled out from a back room dedicated to an indoor grow operation, a typical set-up with lights and pop-up grow tent for up to 12 plants.

CITY LIFE.KEVIN LAWRENCE mugHe grew pot, he said, to bring in a little extra cash flow. His disability payments weren’t enough to cover his expenses, which consisted mostly of caring for his dogs, dining out and women he met on the internet. He grew decent weed and I helped him on a number of occasions, trimming, getting his product ready for market.

“Jeesus! You’re slow,” he said. “That’s the best you can trim? I could hire a retard who’s faster than that.”

“Dude, I’m a bit older than you. These fingers don’t work so well anymore.” Invariably, one of his three dogs would come around the coffee table upon which we worked to get some attention. He brushed up against one of the big 32-gallon bags of finished trim on the floor and put his head on my lap.

“He’s the sweetest, dog,” Kevin said, snipping away. “Always looking for love. Watch out he doesn’t jump up on the couch behind you!” And sure enough, the dog climbed up and squeezed himself between me and the couch, nuzzling his head into my back.

His dogs were his best friends, like beloved foster kids he’d raised, and had been for many years, through the best and worst years, through the prosperous porn years when, he claimed, he made millions and owned a lakefront home where he and the dogs could swim and play all day; and through the devastating loss of everything he ever owned—except the dogs—through a bitter divorce, which jaded him.

“My ex is a fucking bitch, dude. I gave her everything she could ever want and she just turned around and fucked me in the ass with it.”

He had a medical with one of his dogs, trained as a service dog and companion, who wore a vest indicating to all concerned Kevin’s most serious health issue—a mental illness that he freely admitted.

“I’m fucking crazy, dude, and this place is only making it worse.”

Kevin’s not the first Cayucos resident with a mental illness. There have been several. He was refreshingly honest about his, even though at times it got unbearable to hear him talk about how fucked up his life had become, how he’d gladly kill himself, and eventually would if he didn’t get out of this town quick. The only thing that stopped him, he said, were his dogs.

“I’ve gotta stick around and take care of these knuckleheads.”

He talked of moving back, with some desperation, to Santa Monica, where he had “true” friends and the world felt more familiar and real, less parochial and small and elitist and phony than Cayucos.

“This town’s so fucking small, dude,” he’d say, followed by a litany of complaints about the weakness of some men here, and the eagerness of some women, including their wives, who would come to his door in the middle of the night to fuck.

“If you don’t like it so much,” I said, “move! Go someplace where you can be happy!”

“As soon as I get enough money, I will. I’m fucking outta here.”

He loved the macabre, and the deep-felt poetry of the outcast and the malcontent and proudly displayed his parrot-sized tattoo of Charles Bukowski’s grizzled face on his shoulder and arm. He’d share it with anyone who showed an interest in the author.

“You like Bukowski?” he’d ask, rolling up his sleeve. “Here, check this out.”

He scanned the internet for possible hookups with women half his age. Periodically, he’d start an online “relationship” with one of these various exotic and sexy women who sent nude photos, and long, heart-felt notes of endearment, and eventually requests for money. He showed me the Facebook account of one of his twenty-something lady friends.

“Check her out! She’s gorgeous, fucking beautiful,” he said, pointing at his computer screen. “Can you believe it? I can’t believe a girl like that would be interested in a guy like me, my age, fucked up as I am. She’s asked me to pick her up in LA next week. All I gotta do is send her five-hundred bucks.”

Each one, of course, was a scam. He’d lost hundreds of dollars sending money to fake Facebook accounts claiming to be women who said they couldn’t wait to meet him in person. I tried to warn him, “Be careful,” I’d say, “save your money.”

I never quite knew what to believe from Kevin, who kept busy with a variety of schemes, always looking for an angle to make some extra money, or score a fuck-buddy, or even a steady soul mate. He never quit, although he regularly threatened to end it all by blowing his brains out.

He had a generous spirit, offered to help when he could. “I’ve got a route of about four or five mow-and-blow accounts,” he told me once, when I needed to earn some quick cash. “They’re shitty accounts and I hate fucking doing them. They’re yours, if you want them.”

We used to meet at Top Dog coffee shop in Cayucos for occasional conversation. He’d spend hours there sitting at the bar, eating a bagel, talking to the baristas, always pushing the limits of propriety with come-ons and sexual innuendos, never doubtful for a moment that one day one of them would come home with him.

Eventually, the owners built a barrier at the bar, making it impossible for whoever sat there to converse with the baristas. “What’s up with the wall?” I asked one day.

“The owners put it there so that guy, Kevin, won’t harass the baristas anymore.”

I helped him compose a letter to Bukowski’s widow, asking her to consider collaborating with him as a promoter, and website facilitator, of her late husband’s work. He’d developed other sites, he told her, including a dating website aimed at locals, which he hoped would go national, and a porn site.

He had the contacts too to make it happen, he said, and if he could just land this gig with Bukowski’s widow, he’d be set. “If she’d agree to something like fifty-thousand a year, I’d be just fine.”

He delivered the letter through an attorney, a lifelong and dear friend in LA. We never heard back from Bukowski’s widow. The attorney, whom Kevin considered one of his closest pals and confidants, who frequently visited Cayucos to commiserate with Kevin, committed suicide in February, 2014.

“That fucker! I was supposed to be the one who killed himself.”

It was a devastating blow and he appeared to decline even faster. I saw him less and less, and we talked less frequently as he became embittered and morbid, and angry at everyone in town, including me, just another Cayucos phony.

Sooner or later, Kevin figured, one of his schemes would take, and get him out of the month-to-month doldrums of collecting disability checks. He couldn’t wait to relocate, and all his energy went into moving back to LA, where at least he could tell the true colors of his neighbors.

I felt bad for him, didn’t know what to say and wished him well, not quite able to decipher truth from fiction any more. Kevin’s world, it seemed, had turned into a dark and morbid nightmare.

CITY LIFE.KEVIN.Rapidfire

Rapidfire band members: Bill Bailey (Axl Rose™), Kevin Lawrence, Mike Hamernik, Chuck Gordon.

His most recent project, before moving away from Cayucos, was his lawsuit against Bill Bailey, later known as Axl Rose of Guns N’ Roses fame. They had performed together in a band called Rapidfire, Kevin claimed, before Bailey made it big.

He had filed suit to make public some unreleased recordings, an EP, Ready to Rumble,  that he and Axl made together. His plan was to turn a mint selling the new releases of Axl’s early, pre-Guns ‘N Roses career. He guessed millions, if only Axl would let them go.

“Axl’s being an asshole about it,” he claimed, “won’t release the tapes, so I’m suing the fucker.”

I listened with half interest, not knowing whether any of it was true, but wanting something good to happen for Kevin. HIs much-heralded Cayucos conquests, frequent online disappointments, and braggadocio over and scorn for the community, jaded me.

“That’s great, Kevin. I hope you it works out for you.”

Meanwhile, he pursued his usual routine, mostly sleeping in late, grabbing coffee mid-afternoon, growing pot and taking his dogs to the pool for exercise. Occasionally, he’d swing down to the Tavern or the Old Creek Ale House and inform anyone who would listen about his early days playing lead guitar for Axl, and how fans would be blown away by the quality of the tracks.

“They’re gonna shit, dude. When they hear this stuff, they’re gonna shit their pants. Axl’s early work, never heard before. Do you have any idea how much that shit’s gonna be worth?”

Toward the end, he seldom washed, his hair dirty and matted, pugnacious face grimy and oiled, but claimed he was regularly getting laid at all hours of the day, nearly every day of the week.

Eventually, he went back to Southern California, where he hoped to connect with old friends, perhaps with Bukowski’s widow to offer his services. Not long after he left Cayucos, however, in January, Kevin Lawrence died from heart failure and pneumonia. He was 51.

I learned of his death through an online heavy metal magazine, Metal Sludge, that confirmed, in fact, Kevin’s claim to fame, that he’d cut an unreleased album with Axl Rose.

At first, word of his death came as a shock only because he’d convinced me that one day he’d kill himself. It was just a matter of time. After one of his dogs died and he hadn’t taken his own life, he said: “I’ve got these two other guys to look after. But I guarantee you that when they go, I go.”

Death by pneumonia seemed the most artless way to go, at least for a guy who wanted to exit with a bang, for someone who wasn’t ashamed to admit his mental illness, and had a plan for how he was going to end his days.

I still have the book he loaned me, “A Happy Death,” by Albert Camus. I never finished the book. I doubt that death through pneumonia is a happy death. I wish his had been a happy death, but who ever heard of a happy death?

I would rather he had taken his life in the dramatic way that he first described, even though it made me sick to hear him say it. I can’t bear to think the real suffering of slowly, painfully losing your breath and drowning in your own fluids as the world closes in and turns dark. He deserved better, even if he suffered, as he freely admitted, from a serious mental illness. §

Stacey Warde is publisher of The Rogue Voice. Comments, inquiries and contributions are always welcome. He can be reached at roguewarde@gmail.com.