Enough With the Diagnoses!

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“Donald Trump is a sociopath / has narcissistic personality disorder / has ADHD / has Alzheimers / has XYZ.” I see it over and over on social media from people with medical credentials (who should know better) and people with no medical credentials (who need to learn better.)

It does not serve any useful purpose to diagnose another person from afar, and for professionals, it is a serious breach of ethics.

Don’t believe me? Here’s what the American Psychiatric Association has to say on the subject.

Now you may say, oh, that only applies to medical professionals!

Judaism also has something to say about this kind of talk, for all Jews. For this we have to use a couple of texts. First:

When a man has in the skin of his flesh a rising, or a scab, or a bright spot, and it becomes in the skin of his flesh the plague of tzara’at, then he shall be brought to Aaron the priest, or to one of his sons the priests. – Leviticus 13:2

The Torah is very cautious about illness. On the rare occasion it speaks of it, it demands that an expert make a diagnosis. We in the 21st century don’t regard kohanim (priests) to be experts on disease, but in Biblical Israel they were trained to recognize tzara’at (the skin disease often mistranslated as “leprosy”) and to recognize many internal problems in animals. In this case, people are actually forbidden to diagnose themselves or others; they are commanded to go to the expert.

You shall not go up and down as a talebearer among your people; neither shall you stand idly upon the blood of your neighbor: I am Adonai. – Leviticus 19:16

This is the famous prohibition against rechilut [gossip]: Even when our words are true, we are not permitted to talk idly about other people. How much the moreso when we talk about a judgment we are not qualified to make? How much the moreso when it is about a judgment that a qualified expert would not make because it would be unethical for them to do so?

Now you may be saying, “But rabbi! It’s obvious that Mr. Trump has XYZ! Here is the evidence in his tweet or his behavior!” That which is obvious is not necessarily true. An example: An elderly woman becomes forgetful. She gets lost on a walk. Her children are distressed and say, “Oh, it is obvious that Mom is getting Alzheimers!” But when mom falls at home and is taken to the hospital, the diagnosis she receives isn’t Alzheimer’s. It turns out that her medications have been the culprit all along. After her meds are adjusted, she returns to her old self. It may have obvious to her children that she had Alzheimer’s, but their amateur diagnosis was false.

A second problem: Most people who talk about Mr. Trump having “XYZ” disagree with his politics and/or his behavior. We have a habit in our society of using words like “crazy” or “insane” when people behave in ways we don’t like. Sometimes it is an attempt at a benign explanation or excuse (“The shooter must have been mentally disturbed!”) The trouble with these words is that they also reinforce the inverse: they suggest that someone who is mentally ill is likely to be a criminal. In fact, most people with mental illnesses are highly unlikely to be dangerous to others. The meme of the “dangerous psycho” perpetuates discrimination against these largely harmless people.

So when I call someone I don’t like, or whose behavior I don’t like, a “mental case,” I am not doing anything about that person’s behavior, I’m just perpetuating a damaging stereotype. That’s not OK.

In the case of a public figure whose words and actions are certainly our business, it’s better to focus on the words or actions themselves.  For instance, it’s perfectly fine – in fact, a civic good! – to point out a lie by citing evidence. It’s constructive to condemn a hurtful or criminal behavior.

Amateur diagnoses of any public official are a waste of time and a waste of valuable public energy. Only a qualified professional who has actually examined a person can make a real diagnosis. A bunch of people on Twitter can go on about how “crazy” someone is or how “he is obviously an example of RPD” but they are just running their keyboards and wasting our time. They are also slandering the vast number of people with illnesses and disorders who mind their own business and hurt no one.

If we are genuinely worried about the incoming administration, we will do better to stick to ethical behavior and actions that will produce results. Some former congressional staffers have put together a very impressive guide to effective action and they have made it available online. That way we can accomplish good and avoid the sin of rechilut.

הִגִּיד לְךָ אָדָם, מַה-טּוֹב; וּמָה-יְהוָה דּוֹרֵשׁ מִמְּךָ, כִּי אִם-עֲשׂוֹת מִשְׁפָּט וְאַהֲבַת חֶסֶד, וְהַצְנֵעַ לֶכֶת, עִם-אֱלֹהֶיךָ

It has been told to you, O human, what is good, and what Adonai requires of you: only to do justly, and to love mercy, and to walk humbly with your God. – Micah 6:8