Mental illness in the Oval Office needs frank discussion
About half of America’s presidents caught a lucky break with the Founding Fathers and the Constitution they crafted in convention at Philadelphia in the summer of 1787.
From among the many criteria the Founders could have considered in determining eligibility to be president of the United States, they settled upon only a few, stipulating in Article II, Sec. 1, that the nation’s chief executive, who would serve also as commander in chief of the national and state militaries, must be “a natural born citizen, or a Citizen of the United States at the Adoption of the Constitution … (must) have attained to the Age of thirty-five years, and been fourteen years a Resident within the United States.”
Neither the Constitution eventually ratified by the 13 state legislatures, nor the convention proceedings detailed by James Madison in his diary, nor the brilliant, sweeping essays of Madison, Alexander Hamilton and John Jay that comprised the Federalist Papers intended to sell the Constitution to the states give hint that the Founders were concerned about the fitness of presidential officeholders – about the quality of their personhood and their substantive qualifications.
One can only speculate as to why the Founders held a constrained view of presidential eligibility. Conceivably, because they were steeped in the 18th-century Enlightenment notion that reason ought to have primacy in the conduct of human affairs, they retained an elemental confidence that whoever might in the future ascend to the presidency would be sound enough in body, mind and demeanor to give life to the principle of reason in the affairs of state. The Founders presumed individually and collectively that reason would be a bedrock of the new American nation and its political system.
Surveying the history of the American presidency, we encounter much evidence of that expectation being honored in the breach. For example, researchers have found that on taking office, some presidents were already suffering seriously from one or another illness with potential to sap their physical strength and undermine their emotional stability in ways that could reduce their effectiveness in office. Among the most notable were Chester A. Arthur, whose chronic fatigue was a symptom of what was then known as Bright’s disease; Franklin D. Roosevelt, who in his early manhood had contracted crippling polio; and John F. Kennedy, whose chronic severe back pain was attributed to Addison’s disease.
Even before taking that office, about half the presidents were already seriously stricken by mental illnesses, which had potential to limit their effectiveness in conducting the affairs of state. Their number, according to scholars, included James Madison, John Quincy Adams, Franklin Pierce, Abraham Lincoln and Calvin Coolidge, sufferers of deep depression; Thomas Jefferson, Ulysses S. Grant, Calvin Coolidge, and Woodrow Wilson, who were beset by social phobia and generalized anxiety disorder; and Theodore Roosevelt and Lyndon Johnson, whose mental illness was bipolar disorder. Lincoln, and perhaps other American presidents as well, occasionally contemplated suicide.
Fast-forward to the present day, when in a bitter electoral contest for the presidency (and reportedly for many years before), the candidate of one of the two leading political parties seems more and more to exhibit the manifold features of a serious mental illness detailed in the American Psychiatric Association’s Diagnostic and Statistical Manual-5: narcissistic personality disorder, some of whose features appear also in other mental illnesses catalogued in the manual, among them megalomania, sociopathy and attention deficit disorder.
NPD’s cause has yet to be confirmed. The preponderant view among psychiatric clinicians and researchers is that it has roots in early-life mismatches in the family constellation and in genetic psychobiology, i.e., in the connection between brain, behavior and thinking.
There is no effective pharmaceutical intervention or cure for NPD, only management of the pathology with psychotherapy, talk therapy, in the hope that the excesses of attendant inappropriate personal and social behavior can be mitigated.
Many Americans worry deeply that should a leading candidate for the presidency seemingly stricken seriously by narcissistic personality disorder win the office, the nation’s security and welfare, and the world’s, will be jeopardized, a view held widely outside the United States.
While this cannot be foretold, in itself raising fears, it is reasonable – given the record of serious illness among American presidents and in light of the current heightened agitation in the American body politic over the mental state of a leading presidential candidate – to consider someday visiting the Founding Fathers’ constrained view of presidential eligibility, and opening a serious public conversation about illness and the presidency, a subject too long closeted and suppressed.
The writer is an emeritus professor of political science at the University at Albany.
This story was originally published November 1, 2016 at 1:48 PM with the headline "Mental illness in the Oval Office needs frank discussion."