PSYCHIATRY Won’t Topple TRUMP — But Disaster Will

As a working psychiatrist of 50 years, I’ve met more people like Trump outside my clinic, than within. Yes, I’ll fix your roof, and they don’t. Yes, I’ll mend your boiler, and it bursts. This isn’t psychiatry, it’s all too common practice — and it doesn’t work. So what? If my roof repairer lies — I get wet — I don’t start World War III. Promises are cheap, chaos expensive.

I love my work — people coming to see me have genuine problems, else why come? Something in their life isn’t working. They don’t invent illnesses they haven’t got — most don’t have the time or the luxury to indulge in that, they’re too busy making ends meet. It’s just that what they ‘normally’ do, no longer works for them, they have worries, or mental pains they don’t want. The challenge for me is to listen carefully, evaluate ‘normal’ from what they are doing that doesn’t work, and then nudge them in that direction. They want personal change for the better. Trump doesn’t.

Since I qualified in 1961, I cannot readily recall anyone who pretended to have a disease they didn’t — many, if not all, are confused, yes, some with weird and totally inaccurate versions of disease — but lying to me, I don’t think so. Medically this is malingering, and I’ve written a long piece about it (https://medium.com/@BobTrustConsent/how-why-trumps-lies-damage-health-both-medical-and-social-a08fbbc56df1#.bcoy4bqkg). Obviously telling your doctor what isn’t true, is a mugs game. You risk having operations or other unnecessary treatments for non-existent conditions inflicted on you, and then you are liable to meet up with some all too real side-effects — no treatment is ever 100% risk free, and some adverse effects are ferocious.

What applies in my clinic, applies everywhere else too. Put on a medical hat, and look at some of our crippling social diseases — the Rust Belt, the Corruption, the Plutocracy. What’s your diagnosis? Get the diagnosis wrong, and the treatment you vote for can only guarantee to make things worse, just like ‘Austerity’ is now doing for everyone. After all, we all know where the money is, and also where it isn’t.

So back to the opening questions — does our nations’ roof need fixing? Is the global ‘boiler’ awry? If yes, does the honesty of those we pay to fix it, matter? Remember, promises are cheap, but chaos is costly. Those leaders of society, the ones we fund to guide us through our political tangles — what if they pretend to solve things, but don’t really have a clue? Familiar enough in repairing houses — what about globally? What to do?

Well, in today’s complex society, we rely on appointees to ‘cure’ or at least ameliorate the inevitable tangles our complexities land us in. Obviously, as a citizen you can’t be everywhere — you delegate to others, people you no longer know. When we all lived in the same village, we’d know everyone — but today is different, time to catch up. We are required to ‘trust’ politicians to get the job done, the right job that is, not some fantasy of ‘evil’ they’ve dreamt up. And there’s the rub. What if they see lying as a way of getting by, what if distorting reality, verbally, is what they routinely do, almost without noticing. The trouble is, however ‘smart’ you are, if you treat the wrong disease, you ensure things get worse. Chaos awaits all of us just round the corner, and the more power or energy in play, the greater the chance of disaster. And you can’t ‘over-promise’ your way out of that one.

As a president or prime minister you cannot do everything yourself — no one has eyes in the back of their heads, so you delegate to people who think and behave like you — you find them more comfortable. So if you favour exaggerating your own abilities, you’ll tend to attract people around you who do likewise. If you, personally, are not thinking straight about Brexit, why not muddle the task by hiring three egos, and watch them bicker.

Politicians promote people who fantasise along the same tram lines they do. This isn’t psychiatry, it’s common experience. Don’t forget what you’ve learnt about buying second hand cars. To begin with, everything sounds wonderful — but then unreality bites, and something like the transmission dies. Promises are cheap, but the next global chaos could well cost all of us, everything.

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Dr Bob Johnson, consultant psychiatrist. Www.DrBobJohnson.org

Saturday, 18 February 2017