civic life and health research

Posted on May 31, 2017 by Peter

This is an online lecture (video, slides, and discussion questions) entitled “Civic Life and Health Research.” It’s offered by, and thanks to, the Tufts Clinical Translational Sciences Institute (CTSI), where I hold a research professorship. Dr. Thomas Concannon introduces the CTSI and the session. I then offer four frameworks for understanding civic life:

social capital
collective efficacy
common pool resources
the public sphere

For each one, I explain why there are important empirical and conceptual connections with public health that have implications for both research and practice. Public health really serves as an example to illustrate how to apply these concepts, so the talk might be of some use in other fields as well, such as education or economic development.

(You can find and register for other free CTSI courses here.)

college curricula for civic learning and engagement

Posted on May 30, 2017 by Peter

I’d welcome recommendations of particularly promising undergraduate courses or programs that are intended to boost students’ civic knowledge, skills, and engagement. I’m especially interested in two approaches: 1) requiring a specific course with a civic focus for all students at a given institution, or 2) offering a major, minor, or certificate program for especially interested students.

Civic education at the college level may address contested concepts (justice, citizenship, democracy), skills (from facilitating meetings to reading regression tables), bodies of knowledge (how a bill becomes a law; the texture of the local geographical community; social determinants of health …), self-understandings and identities (“Who am I and what is my role in the community?”), and relationships among students or between students and others. The list of possible outcomes is so long that one reasonable view is: A civic education is a liberal education–it’s the whole curriculum and co-curriculum. But it’s valuable to consider what to offer (or perhaps even require) in the finite span of one course or one major.

Many colleges and universities require first-year seminars. Students can typically choose a course from a menu, but all the seminars create a similar experience, which is supposed to build a community among the students. To the extent that first-year seminars address issues of civic importance, this is also a way of teaching ideas and skills relevant to citizenship. At Cal. State Chico, the guiding principle of the first year seminar program is “Public Sphere Pedagogy.” Chico aims to shift “from a typical classroom setting” to real public dialogues with “diverse campus and community members.”

Other institutions require a particular course or sequence of courses for all students. Columbia’s Core Curriculum is a distinguished example that dates to the early 1900s. Since Columbia’s Core course on “Literature Humanities” has included the Iliad, Oresteia, and Inferno for all of its 75 years, every Columbia College student since WWII has read those books. “The communal learning–with all students encountering the same texts and issues at the same time–and the critical dialogue experienced in small seminars are the distinctive features of the Core.” One could focus mainly on formal, historical, or theological issues while reading texts like the Inferno; but among the topics emphasized in the Core seminars are explicitly civic ones: “What does it mean, and what has it meant to be part of a community?” “By what rules should we be governed?”

At Florida Gulf Coast University, all 13,000 students must take the University Colloquium, an “interdisciplinary environmental education course designed to explore the concept of sustainability as it relates to a variety of considerations and forces in Southwest Florida. In particular, we will consider environmental, social, ethical, historical, scientific, economic, and political influences.” The Colloquium requires 10 hours of service, which can go toward FGCU’s universal requirement of 80 hours for graduation.

Note the interesting difference in content focus: classic texts at Columbia; the local physical and human environment at FGCU.

At least 31 institutions offer majors with titles like “Civic Engagement,” “Service Learning,” “Civic Leadership,” “Community Service,” or “Leadership, Ethics, and Social Action,” and variations on those themes.* I would add majors in “Peace & Justice Studies,” “Advocacy Studies,” “Citizenship & Civic Engagement,” and others to this list.

These programs almost always require community-service experiences or internships. Most also require a foundational course. Butin* finds that the content of these courses varies a great deal. The most frequently assigned material is research about civic engagement in America, e.g., Robert Putnam’s Bowling Alone or excerpts from de Tocqueville; but those particular texts are assigned in a minority of all the foundational courses.

Majors are usually more ambitious than minors or certificates, but a program like the University of Maryland’s Civicus is not only a certificate with some required courses; participants also live together in a dedicated dorm and conduct service projects beyond their courses. In that situation, a certificate may be more intensive than a major.

I view public policy programs (whether undergraduate or graduate) as somewhat different from programs in civics. I like to say that the question for Civic Studies is “What should we do?” whereas the question for public policy is “What should be done?” (Or, “What should a policymaker do?”) However, public policy programs can emphasize the citizen’s side of policymaking. Some assign all their students to participate in simulations in which they role-play various official leaders in a fictional crisis. These simulations typically fill a limited number of days before the main coursework begins and serve to build a community while teaching civic skills. I am not aware of any institution that offers or requires a simulation for its whole undergraduate student body, but that’s an interesting prospect.

* Dan Butin, “’Can I major in Service-Learning?’ An Empirical Analysis of Certificates, Minors, and Majors,” Journal of College & Character, vol. 11, No. 2 (2010), pp. 1-18.

psychoanalyzing presidents

Posted on May 26, 2017 by Peter

There’s lots of conversation right now about Donald Trump’s mental condition. It includes claims that he demonstrates narcissistic personality disorder and that changes in his speech patterns reveal cognitive decline. I [analyzed] his speech pattern from a particular angle here.

This discussion evokes the episode in 1964, when Fact magazine surveyed psychiatrists about then-candidate Barry Goldwater’s psychological fitness to be president.

Just under half (49.2%) of the 2,417 respondents thought he was unfit, with the rest split evenly between those who didn’t believe they could answer and those who considered him fit for office. Fact also gave respondents a chance to write comments and printed 40 pages of quotes from their answers. Goldwater sued and won over $1 million in damages (which bankrupted Fact magazine), leading to the American Psychiatric Association’s “Goldwater Rule,” which forbids members from making evaluative comments about public figures whom they have not examined as individual patients. A patient/physician relationship triggers ethical responsibilities that are absent when psychiatrists discuss public officials.

For me, the original Fact magazine issue is a fascinating example of professional authority encountering politics. It’s important to note that a considerable minority of the quoted statements either object to psychoanalyzing Goldwater without examining him in person or vouch for his mental health. Some of the surveyed psychiatrists even opine that he is the only sane candidate, surrounded by crazy socialists. But the majority of the quoted MDs make claims that now seem risibly dated and morally problematic. They do so under their professional titles, in a magazine entitled “Fact.” For example:

“Descriptions of his early life that I have read indicate to me that his mother assumed the masculine role in his family background. … The picture, therefore, is of a domineering, emasculating mother and a somewhat withdrawn, passive, narcissistic father. … This would provide a fertile background for sado-masochistic temperament, such as is seen in paranoid states.” — M.D., name withheld.
“From TV experiences, it is apparent that Goldwater hates and fears his wife. At the convention, she consistently appeared depressed and withdrawn. Certainly she was not like the typical enthusiastic candidate’s wife, e.g., Mary Scranton.” — M.D., name withheld.
“Barry Goldwater’s mental instability stems from the fact that his father was a Jew while his mother was a Protestant. This ethnic and cultural split accounts for his feelings of insecurity and spiritual loneliness. … ” — M.D., name withheld.
“In trying to analyze Mr. Goldwater’s behavior I am tempted to call him a ‘frustrated Jew.’ … He has never forgiven his father for being a Jew. … What the Senator from Arizona stands for is the antithesis of the traditional Jewish concepts of social justice, of humility, of moderation in speech and action, and of concern for the feelings of others, especially the vanquished. In eschewing these concepts, the Senator subconsciously expresses his hatred for his Jewish father.” — Max Dahl, M.D. Supervising Psychiatrist [etc.]
“In allowing you to quote me, which I do, I rely on the protection of Goldwater’s defeat at the polls in November; for if Goldwater wins the Presidency, both you and I will be among the first into the concentration camps.” – G. Templeton, M.D., Director, Community Hospital Mental Health [etc.]
“Characterologically, Goldwater is like many middle-class Americans. He is ‘formula’ oriented with a belief in the infallibility of his own rhetoric. … In short: Goldwater is an anal character who believes all’s well in his ‘tidy’ world.” — M.D., name withheld.
“From his published statements I get the impression that Goldwater is basically a paranoid schizophrenic who decompensates from time to time.” — M.D., name withheld.

I think we should talk about Donald J. Trump’s character and psychological fitness for office. It seems problematic to use the Goldwater Rule to keep the whole psychiatric profession out of this discussion. And yet these quotes from 1964 remind us how historically-relative, value-laden, and agenda-driven people can be, even when they present themselves as scientific specialists dealing only in Facts.

social movements depend on social capital (but you can make your own)

Posted on May 24, 2017 by Peter

The Montgomery Bus Boycott was the glorious chapter in the American Civil Rights Movement that began when Rosa Parks refused to give up her seat on the segregated bus. This story is usually misrepresented in ways that hide Parks’ planning, leadership, skill, and feminist radicalism (see the real Rosa Parks). In any case, at least 99 percent of the city’s African Americans quickly started boycotting the bus company. That meant that 17,500 workers needed a different way to get to work.

At first, Black-owned taxi companies carried them for the price of a bus ticket, but then the city threatened to enforce a minimum-fare law. Next, more than 150 people volunteered to drive boycotters to work in their own cars. These volunteers “responded immediately,” Martin Luther King recalls in Stride Toward Freedom, but “they started out simply cruising the streets of Montgomery with no particular system.” That must have meant that many workers missed getting available rides. Ministers responded by calling for new volunteers from their pulpits, and even more drivers came out, but that meant (King writes) that “the real job was just beginning–that of working out some system for these three hundred-odd automobiles, to replace their haphazard movement around the city.”

Committees were formed and roles were assigned. It was easy to identify [morning] pickup locations, because African Americans lived in dense urban neighborhoods. But “we discovered that we were at a loss in selecting [afternoon] pick-up stations,” because domestic workers were employed all over the White neighborhoods. Two Black postal workers helped design regular routes. King recalls all this organizational work with evident pride, and concludes, “Altogether the operation of the motor pool represented organization and coordination at their best. Reporters and visitors from all over the country looked upon the system as a unique accomplishment.”

I’d like to draw two theoretical implications from this story.

First, we tend to think of social movements as examples of contentious politics, along with protests, strikes, and even revolutions. Contentious politics has a substantial literature. A separate literature concerns how communities organize themselves to provide services and manage common resources over the long term. For the most part, these two discussions are rather separate. They draw on different disciplines and have different dominant rhetorical styles. But actual social movements rely heavily on what could be called “common pool resource management.”

The two postal workers who designed routes exemplify lessons from the research of Elinor Ostrom and her colleagues: local people tend to have the most detailed relevant information; clear rules enable coordination; and public goods can be rotated geographically to serve many people. I’ve been arguing that we should combine the political-economy of Elinor Ostrom with the insights of Gandhi and King for a more complete civic theory.

The practical implication is that people who want to confront power often benefit from learning how to organize systems and processes that look like nonprofit enterprises.

Second, it’s commonplace to note the dependence of the civil rights movement on “social capital,” especially in the form of churches and unions. Both institutions play explicit roles in Dr. King’s narrative of Montgomery. But this analysis can leave you at a loss if you’re part of a community that doesn’t happen to have much social capital. And social capital can be mysterious, for it is invisible, and its connections to tangible outcomes seem obscure.

Indeed, social capital is a metaphor: Montgomery’s African Americans did not have a literal deposit of social capital in the bank. When social capital is measured by asking individuals about their tendency to join groups and to trust one another, it’s hard to see how we could boost these assets or why they would be important politically.

A different way of looking at social capital is as a concrete capacity to solve collective-action problems, such as providing free rides to 17,500 people every day. That may have been easier in Montgomery because so many people were already organized in other successful, functioning groups, such as the Black churches. “Labor, civic, and social groups were our staunch supporters,” King writes, “and in many communities new organizations were founded just to support the protest.” Like other forms of capital, social capital can be built up in one place and used in another. But what mattered was actually organizing the carpools to sustain the boycott. Skillful citizens can pull off such successes even in the absence of existing high levels of social capital, when they design good structures.

In short, social capital is a metaphor for self-organization, and people can self-organize.

youth don’t always tilt left

Posted on May 23, 2017 by Peter

is everyone religious?

Posted on May 22, 2017 by Peter

In the perennial debate about the place of religion in politics and public life, one available stance is: “Everyone is religious.” This position has weaknesses, which I will mention below, but here are three points in its favor:

Ethical people hold beliefs that are hard, if not impossible, to justify with empirical evidence. For example, I believe that all human beings are equal. That is not a scientifically demonstrable claim. Science finds all kinds of inequalities of capacity, potential, and importance among actual human beings, who include speechless infants and late-stage Alzheimer’s patients. Equality is instead a moral premise. I don’t happen to take it directly from an overtly religious source, but it could be viewed as similar to a religious statement, such as “God loves the world.”
Everyone should recognize that the universe exceeds our capacity to understand it, even by means of cumulative empirical research. I know things that our dog just can’t. I know, for example, that he and I live in the United States, which is a republic. Perhaps he knows some things that I can’t. With appropriate tools, I could collect the same information that he takes in with his remarkable nose, but I wouldn’t know what it feels like to sense that a cat crossed “his” yard five hours ago. A creature with a much different brain from either my dog’s or mine could know things that neither of us can. One needn’t believe in God, then, to acknowledge the likelihood that the universe is permanently unknowable by us and a place of mystery.
Religions do not have foundational articles of faith from which all their other beliefs flow. Sometimes they present themselves that way. Some Jews say that the whole Law follows logically from the revelation on Sinai; some Christians, that everything is implied by God’s sacrifice of His Son on the cross; some Muslims, that everything results inevitably from believing in God and His last prophet. But I don’t think these claims do justice to their respective traditions. Religions are actually large webs of metaphysical beliefs, stories, characters, rules, examples, traditions, rituals, and hopes. Everyone has such a web, whether we see ourselves as religious or not. In fact, many items in the idea-network of a religious person are also present in my network.

In the end, it’s probably a mistake to lose the category of religion or to view religious worldviews as completely parallel to secular ones. The main reason is sociological. Since (I think) the Babylonian Captivity, the Abrahamic religions have organized themselves in a certain way within larger societies. They treat membership in the religious community as an identity: something you are, not just a set of ideas you endorse. They view certain texts as canonical. They emphasize beliefs that are matters of faith (“things hoped for, evidence of things not seen”) over memories or observations. And they gather their believers in groups that form larger networks or structures. The original meaning of the words “congregation,” “synagogue,” and ecclesia (Greek for “church”) is coming-together, a tangible social act. I think the great Asian traditions have been influenced by these sociological forms and have begun to look somewhat like Abrahamic faiths, as a result of isomorphism.

Such religions operate as identity groups and convene in organized structures. They can thus be oppressed and persecuted but can also dictate to others when they control power. That means that a liberal state is wise to identify religions for protection but also to make the government and law neutral among religions. The reason is not metaphysical or epistemological–it’s not that religious people fundamentally believe in different kinds of truths or think in different ways from secular people–but sociological. Religions function differently from other clusters of beliefs and practices.

However, if we adopt this position, then we should at least inquire into whether certain secular belief-communities have also taken forms parallel to those of the Abrahamic faiths, again perhaps due to isomorphism. Doesn’t, for instance, medical science offer its own bounded identities, canonical texts, hierarchies, moral premises, rituals, heroes, and exemplary cases? If it does, then possibly it should be viewed as similar to a religion–which is an idea as old as Durkheim.

I would be reluctant to draw radical implications for US constitutional law. Our traditional ways of defining and protecting religions reflect some pragmatic experience and help to constitute our political culture. I wouldn’t necessarily rock that boat. But if the question is not “How should the Supreme Court interpret the Establishment Clause?” but rather, “What distinguishes religious thinking?” then I am inclined to suspect that everyone is religious and that religion is everywhere.

the Hollowing Out of US Democracy

Posted on May 19, 2017 by Peter

In lieu of an original post here today, I’ll link to a new post of mine on The Evidence Base, a group blog from CESR, the Center for Economic and Social Research at University of Southern California. I argue that the decline of certain types of associations has left many Americans, especially White working-class citizens, in what my colleagues at the Tisch College of Civic Life and I call “Civic Deserts.” This trend does not explain why a Republican president won in 2016 or why he has taken certain views of policy and ideology. But it does explain the appeal of his leadership style. Citizens who have never belonged to everyday local associations with responsible and accountable leaders do not expect such leadership from their president.

I also explain my SPUD framework, which stands for Scale, Pluralism, Unity, and Depth. SPUD, I propose, is the recipe for effective civic and political organizations, but it is difficult to achieve and is much scarcer today than decades ago.

mini-conference on Facts, Values, and Strategies

Posted on May 17, 2017 by Peter

We are about to begin discussions of the papers listed below, in draft form. They are destined for The Good Society journal. The conversations are at the Tisch College of Civic Life at Tufts

For me, the underlying rationale goes like this. A good person is always asking “What should I do?” That question must become plural–“What should we do?”–for two reasons: we cannot accomplish enough alone, and we must reason together to improve our opinions. Both questions integrate facts and values. Something that works but isn’t good is not what we should do. Likewise, we want to avoid something that is good but doesn’t fit the circumstances of the time and place.

The structure of intellectual life in modernity frustrates asking these questions, for several reasons. One major reason is that matters of value are assigned to certain disciplines in the humanities, while matters of fact go to disciplines that widely imitate science and present themselves as value-free.

It’s easy to call for a reintegration of facts and values (and strategy), but very hard to pull that off. Fortunately, we have traditions of thought–always contributed by many thinkers and practitioners rather than a single luminary–that do reintegrate facts, values, and strategies. Names that stand for these traditions include Gandhi, Pope Francis, Hannah Arendt, William James, Amartya Sen, Elinor Ostrom, and Jurgen Habermas. These names recur in interesting combinations in the following papers. So do certain themes: the limitations of human cognitive abilities and the positive potential of certain kinds of affect; the value of institutions for structuring deliberation; the link between work and reflection; and the value of deep, responsive uncertainty–wonder.

“Public Entrepreneurship, Civic Competence, and Voluntary Association: Self-Governance Through the Ostroms’ Political Economy Lenses” — Paul Dragos Aligica, George Mason University

“Giving Birth in the Public Square: Dialogue as a Maieutic Practice” — Lauren Swayne Barthold, Endicott College and Essential Partners

“William James’s Psychology of Philosophizing: Selective Attention, Intellectual Diversity, and the Sentiments in Our Rationalities” — Paul Croce, Stetson University

“Democracy as Group Discussion and Collective Action:Facts, Values, and Strategies in Rural Landscapes” — Timothy J. Shaffer, Kansas State University

“Social Media, Dismantling Racism and Mystical Knowing: What White Catholics are Learning from #BlackLivesMatter” — Mary E. Hess, University of Toronto

“Institutions, Capabilities, Citizens” — James Johnson, University of Rochester, and Susan Orr, SUNY College at Brockport

“Forgiveness After Charleston: The Ethics of an Unlikely Act” — Larry M. Jorgensen, Skidmore College

“Facts, Values, and Democracy Worth Wanting: Public Deliberation in the Era of Trump” — David Eric Meens, University of Colorado Boulder

“The Praxis of Amartya Sen and the Promotion of Democratic Capability” — Anthony DeCesare, St. Louis University

“A Civic Account of Justice” — Karol Edward Soltan, University of Maryland

American tapestry

Posted on May 16, 2017 by Peter

6:10 am, Monday, Boston, MA: My taxi driver is a retired guy from the South Shore. His son is a Ranger, active duty. The son curls up on the floor now when fireworks go off: PTSD. He is friends with all the generals, ever since he use a banned weapon in Afghanistan to save some guys despite the orders of an interfering German NATO officer. According to him, the US generals believe we have to stop fighting all these little wars, because then the media turns every bit of collateral damage into a war crime. We need one big war to just end it.

3:30 pm, Monday, Ferguson, MO: I am getting a detailed and extraordinarily well-informed and thoughtful driving tour through this city, traversing all the main roads plus several of the back streets and cul-de-sacs. My guide, an African American woman and longtime resident of Ferguson, is also a scholar with a PhD, an educator, and an activist. Through her windshield, Ferguson looks remarkably ordinary: Anywhere, USA. Sam’s Club, Walmart, mowed median strips, the Interstate, tidy homes of brick or wood, low-rise apartment complexes, some fancy older houses along one side of town, and knots of happy kids walking home from their schools. It is Anywhere, USA–which is the problem.

7:30 pm, Monday, Kansas City, MO: Sitting at the bar of a BBQ restaurant that caters to tourists, with baseball on the TV screens and the news on my smartphone that the President of the United States has casually divulged secret information to the Russian ambassador.

what does it mean to attribute narcissistic personality disorder to a person?

Posted on May 15, 2017 by Peter

(St Louis, MO) We have two rival languages for analyzing personality: the medical and the moral. They are largely incommensurable, yet cases force us to choose between them.

For instance, psychiatrists and pundits are currently debating whether to diagnose Donald Trump with “narcissistic personality disorder.” The Mayo Clinic tells us that the DSM-5 defines this disorder using the following criteria (of which five are normally considered adequate for a diagnosis):

Having an exaggerated sense of self-importance
Expecting to be recognized as superior even without achievements that warrant it
Exaggerating your achievements and talents
Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
Believing that you are superior and can only be understood by or associate with equally special people
Requiring constant admiration
Having a sense of entitlement
Expecting special favors and unquestioning compliance with your expectations
Taking advantage of others to get what you want
Having an inability or unwillingness to recognize the needs and feelings of others
Being envious of others and believing others envy you
Behaving in an arrogant or haughty manner

All “disorders” defined in medical discourse are like diseases or injuries. Any disorder must be found repeatedly in a population: the various criteria must cluster statistically. It must harm the individual who suffers from it: the patient. The harm usually takes the form of preventing the patient from enjoying “normal” or healthy functioning. Medical science seeks to explain the disorder as a result of prior causes, and it looks for treatments that prevent, remove or at least mitigate any impairment.

Medicine marginalizes moral judgments. Even if you broke your leg because you were jumping on your bed, once you get to the ER, you’re a patient suffering from a fracture, and the point is to make you better so that you can jump again.

Thus the Mayo Clinic uses its standard format (Definitions, Symptoms, Causes, Risk factors, Complications, Preparing for your appointment, Tests and diagnosis, Treatment and drugs, Lifestyle and home remedies, and Prevention) to discuss narcissistic personality disorder, exactly as it discusses strep throat. It’s all addressed to the patient, who is assumed to want to avoid the impairments attributable to this disorder. “If you recognize aspects of your personality that are common to narcissistic personality disorder or you’re feeling overwhelmed by sadness, consider reaching out to a trusted doctor or mental health provider. Getting the right treatment can help make your life more rewarding and enjoyable.”

The causes of narcissistic personality disorder are unknown, but likely suspects fall into two clusters that are equally beyond the control of the patient: “Mismatches in parent-child relationships with either excessive pampering or excessive criticism” and “Genetics or psychobiology.” Complications are said to include “Relationship difficulties,” “Problems at work or school,” “Depression,” “Drug or alcohol abuse,” and “Suicidal thoughts or behavior.”

After preparing for your doctor’s visit and receiving a diagnosis of narcissistic personality disorder, you may be prescribed psychotherapy (which “may take several years” to work) or given drugs for anxiety or depression, because “there are no medications specifically used to treat [this] disorder.”

Moral discourse, in contrast, views every item on the list above as a vice. Olivia says that to be “sick of self-love” is to “taste / with a distempered appetite,” which means misinterpreting what others say. To be sure, our personalities are not fully under our control: parents, genes, and other factors shape us. Still, if we have a vice, we must acknowledge and strive fix it. The primary reason is that it hurts other people. That means that a vice is a vice even if it causes us no “complications” along the lines of “problems at work or school” or depressive thoughts.

Nor does it matter whether vices correlate statistically in a population so that they can be treated as a single syndrome. Each fault stands on its own. However, there may be interesting logical or causal links among specific vices. For instance, maybe it’s because you are “envious of others” that you “exaggerate your achievements and talents.” Since Aristotle, moral philosophers have closely analyzed vices and virtues to understand their logical interrelationships. But even if you happen to be the only person in the world who has put together a given set of moral flaws into its own ugly combination, you need to fix them.

In Vox recently, David Roberts wrote:

All nine [criteria of Narcissistic Personality Disorder] describe Trump’s public behavior with eerie accuracy. But a disorder, by definition, inhibits normal functioning, impedes success. And Trump is inarguably successful. He’s one of the most powerful people in the world. Whatever kind of personality he may have, some psychiatrists argue, he can’t have a disorder. He’s doing well for himself.

These psychiatrists cited in this article epitomize medical discourse. Their standard is the “normal functioning” of the patient who might make an appointment because of an impairment.

I have no doubt that the medical framework has to some extent liberated us. By analogizing psychological problems to diseases or physical accidents, it has challenged the presumption that emotions lie under the conscious control of actors and has put us on the path to at least a few treatments–when otherwise all we would have is censure. In his homage to Freud, who had devoted a whole 1914 essay to Narcissism, W.H. Auden wrote:

[He] showed us what evil is, not, as we thought,
deeds that must be punished, but our lack of faith,
     our dishonest mood of denial,
   the concupiscence of the oppressor.

With Freud’s death, said Auden,

One rational voice is dumb. Over his grave
the household of Impulse mourns one dearly loved:
     sad is Eros, builder of cities,
   and weeping anarchic Aphrodite.

But notice that Auden’s encomium was deeply moral. He rightly saw that the only value of a scientific/medical discourse is its potential to improve the world. If that discourse makes it impossible for us to censure, judge, and demand restorative justice from a person who is harming others, then it is clearly inadequate.

It is a moral, not a scientific, assertion that Trump is a narcissist. Narcissism is compatible with his successful functioning, and it may even partly explain his success to date (although I have the feeling that a reckoning is not far off now). If lots of people exhibit the same set of traits he does, that is interesting; it increases the odds that some kind of drug or standardized treatment may ultimately target the syndrome as a whole. But even if Donald Trump is the only person with his precise list of vices, he merits condemnation. As Lord Byron (who had plenty of personal experience of the matter) observed, “self-love forever creeps out, like a snake, to sting anything which happens, even accidentally, to stumble upon it.”

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