Bandy X. Lee, a psychiatrist, has been dropped from her teaching position at Yale for suggesting, on Twitter, that Donald J. Trump’s associates developed a distorted vision of reality in concert with the former president. Lee leveled the diagnosis of “shared psychosis” specifically at Alan M. Dershowitz. Dershowitz wrote a letter to Yale insisting that Lee had violated the American Psychiatric Association’s prohibition on diagnosing public figures without examining them. Yale fired Lee. She is suing.

Lee wasn’t a tenured or tenure-track professor, but her case highlights a conflict between the competing principles of academic freedom (which in this case also touches on the freedom of political speech) and a professional society’s codes of conduct. The APA established its strictures against diagnosing public figures in part in response to the profession’s hostility to Barry Goldwater’s presidential candidacy in 1964, a hostility expressed by an article in Fact headlined “1,189 Psychiatrists Say Goldwater Is Psychologically Unfit to Be President!”

At stake in the so-called Goldwater Rule, then, is psychiatry’s pretension to scientific objectivity, untainted by the political or ideological predispositions of its practitioners. As Jeffrey Lieberman, chair of the psychiatry department at Columbia, told The New York Times, Lee’s tweets are “problematic for the profession, because it means the profession is using terms too loosely and too glibly. It’s just kind of using a word, a term, that has a clinical meaning and also conveys or connotes a certain level of severity of mental disturbance in a way that’s really inappropriate.”

The discourse of scientific validity, though, might be thought to cut the other way. If “shared psychosis” is a real thing, there’s no obvious reason why, in the case of constantly televised public figures like Trump and his circle, one would need to meet with them in a doctor’s office to diagnose it. There’s no obvious reason, even, that one would need to be a psychiatrist. Gravity is real; I observe its operations every day, and I don’t need to be a physicist to know what I’m seeing. Is it possible that, by over-insisting on the need for special professional paraphernalia (the doctor’s visit and so on) to recognize the objects it studies, the discipline of psychiatry is actually undermining its claims to authority?

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Len Gutkin