I am not the first to say this but it bears repeating – it is wrong to use the accusation of a mental illness as a political strategy. It is unfair, stigmatizing, and dismissive. Thomas Szasz (let me say straight up – I am not a Szaszian) was a psychiatrist who made it his professional mission to make this point. He was concerned especially about oppressive governments diagnosing political dissidents with mental illness and using that as a justification to essentially imprison them.

Szasz had a point (especially back in the 1960s when he started making it) but unfortunately took his point way too far, as often happens. He decided that mental illness, in fact, does not exist, and is 100% political oppression. He took a legitimate criticism of the institution of mental health and abuse by oppressive political figures and systems and turned it into science denial. But that does not negate the legitimate points at the core of his argument – we should be careful not to conflate unpopular political opinions with mental illness, and certainly not use it as a deliberate political strategy.

While the world of mental illness is much better today (at least in developed nations), the strategy of labeling your political opponents as mentally ill continues. I truly sincerely wish it would stop. For example, in a recent interview on ABC, senator Tom Cotton was asked about some fresh outrageous thing Trump said, criticism of which Cotton waved away as “Trump Derangement Syndrome”.

Sorry, but you cannot just make up a new mental illness by framing it in clinical-sounding terminology.  There is no such syndrome, and it is supremely insulting and dismissive to characterize political disagreements as “derangement”. Szasz should be turning over in his grave. This is, of course, and ad hominem strategy – attacking the person rather than the argument. “Oh, you just feel that way because you are suffering from some derangement, you poor thing.” This also can cut both ways – I have heard some on the left argue that it is, in fact, those who support Trump who are suffering from TDS. Some may justify this as “turnabout is fair play”, but in this case it isn’t. Don’t play their game, and don’t endorse the underlying strategy of framing political disagreements as mental illness.

Sometimes accusations are leveled at individuals, which in some ways is worse than accusing half the country of derangement. The most recent episode of this to come to my attention stems from the Arlington cemetery controversy. When the Trump campaign was asked for a statement, this is what they gave:

“The fact is that a private photographer was permitted on the premises and for whatever reason an unnamed individual, clearly suffering from a mental health episode, decided to physically block members of President Trump’s team during a very solemn ceremony,” Cheung said in the statement. (Steven Cheung is a Trump campaign spokesman)

Was it really clear that they were having a “mental health episode”? Why not just say they were “hysterical” and be done with it. By all accounts the person in question acted completely professionally the entire time, and when they were physical pushed aside decided to deescalate the conflict and stand down. My point is not to relitigate the controversy itself, but to point out the casual use of an accusation of mental illness as a political tool. It apparently is not enough to say someone was rude, unprofessional, or inappropriate – you have to accuse them of a “mental health episode” to truly put them in their place.

I am also uncomfortable with the way in which both ends of the political spectrum have characterized the other candidate, in this and previous election cycles. It is one thing to raise legitimate concerns about the “fitness” of a candidate, whether due to the effects of age, or their apparent personality and moral standing. But I think it is inappropriate and harmful to start speculating about actual neurological or psychological diagnoses. This is meant to lend weight and gravitas to the accusation. However, either you are not qualified to make such diagnosis, in which case you shouldn’t, or you are qualified to make such diagnoses, in which case you shouldn’t, although for different reasons. Actual professionals generally abstain from making public diagnoses without the benefit of an actual clinical exam, and those who perhaps have made a clinical exam are then bound by confidentiality. Non-professionals should stay out of the diagnosis business.

It’s best to be conscious of this, and to frame whatever political criticism you have in terms other than mental or neurological illness. Casual accusations of mental illness are cheap and gratuitous, and exist on a spectrum that begins with dismissiveness and includes the abuse of mental illness for political oppression.