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Taking A Stand

The recent political climate in the United States has generated significant cognitive and visceral responses throughout the nation and abroad. Pundits of all persuasions offer interpretations and analyses of the chaos and are often seemingly surprised by each new wrinkle of the chaos that has so far generated an impasse in Congress’s ability to address and correct immediate problems. The generation of these problems stems from the current leadership’s limitations. Early in the election process questions emerged about the presidential candidates’ leadership capacities, styles, and personality. During the course of the campaign, it became apparent that there were some problems in this arena that were particularly acute for one candidate. During that time, many mental health professionals observed behaviors demonstrative of personality concerns that would preclude the ability to fulfill the behavioral capacities expected for the nation’s president. Many psychiatrists began to express their concern, but due to an American Psychiatric Association’s longstanding Goldwater Rule that emanated from psychiatrists publically offering diagnoses of Goldwater’s candidacy years ago, as APA members, they would violate that rule in publically offering a professional analysis in the current electoral fray. Recently, Dr Leonard L. Glass, senior attending Psychiatrist at McLean Hospital in Belmont, MA wrote an Opinion piece in the Boston Globe stating his frustration with the APA’s rule. Interestingly, rather than providing an official diagnosis of the current US President, he simply listed the observational characteristics of the President’s behaviors along with what they suggest operationally. For the most part, these behaviors are consistent and, for the most part, diagnostically predictable. In thinking about the current situation and Dr Glass’ reflection, it occurred to me that what is taking place politically in America is a macrocosmic expression of what pastoral/spiritual care providers, chaplains, psychiatrists, psychologists, and social workers witness at a more microscopic level. An individual’s behavioral and personality problems within any given context, a marriage, a family, or even a business can dominate and affect their entire social context. Such individuals routinely become the focus of each context shifting the dynamic in ways mimicking the problematic behaviors of one individual. Mental and spiritual care providers recognize that such situations can become extraordinarily difficult to disentangle. Frequently, such efforts fail, winding up either in collapse or, at the very least, a separation of the affected individual from his or her social context. These thoughts beg the question about whether professionals, given their knowledge, training, and expertise, ought to speak out, particularly when they observe from afar that an individual’s behavior may threaten many negatively. For example, despite the strict rules about medical privacy, statutes such as the California Civil Code give license to social workers to notify family members of a potential harm a mentally ill family member might impose. Trained and certified pastoral/spiritual care providers recognize the importance of client/patient privacy, but are there times when such boundaries become justifiably unjust and morally indefensible? When the personal and professional values and guild boundaries conflict, how ought they proceed? Should silence in such situations be unjust, even sinful? Such questions are not easily resolved. I invite the JPC&C readership to reflect on such dilemmas and encourage responses, thoughts, and research in this arena. Clearly, the current political environment in the United States poses such questions in stark form. How are we to respond?