Like many opposed to Trump, I enjoy jokes and satiric criticisms at his expense. Trump did not win the popular vote but gained power because of the electoral college, an infected appendix on the body of democracy we refuse to excise. Our anger toward Trump is justified, and it is our duty to exercise our freedom of expression and speak truths to power as often as possible. However, with freedom of speech should come responsibility of speech, as many of us would attest to after watching Trump mock a disabled reporter last summer. The First Amendment may protect Trump, but basic human decency requires us to denounce his expressions of cruelty.
In the spirit of responsible, compassionate use of free speech, I am asking all of us to reconsider use of “psychotic,” “manic,” “demented,” or other psychiatry-based terminology to describe Trump or his behavior. I want to give people who use these words the benefit of the doubt, but please consider the weight of those words. When psychiatric jargon is hurled as insults, it reinforces negative stigmas about mental illness. I am not a psychiatrist, but I have a few teenage patients with psychosis in my pediatrics clinic, and others with manic episodes. My colleagues in adult medicine have patients with dementia. These conditions are struggles. There is nothing to be ashamed of, but my colleagues and I have many patients who avoid care because they are afraid of social stigma about their conditions.
To be clear, reducing stigma against mental illness requires much more than compassionate use of words. Patients, families, and doctors need major upgrades in American mental health systems, including support for Medicaid and funding for a capable workforce. We also need a myriad of non-clinical resources like anti-discrimination policies, stable housing, and employment opportunities. Cleaning up our language does not change the fact we need to do all that work and improve cultural attitudes.
However, words matter. Weaponizing medical vocabulary, even against a foe like Trump, carries consequences beyond the target. Patients struggling with mental illness can not be collateral damage. This is not about political correctness or the stifling of free speech. It is about holding ourselves to higher standards of compassion and decency while exercising freedom of expression to hold Trump and his cadre accountable.
Please know that I am not here to rain (or shower... or golden sho... nope, I gotta finish making my point first) on anyone’s parade. I enjoy humor just for the fun of it. I also believe in the importance of satire and jokes, many of which rely on stinging criticisms and even insults. My request to fellow Americans opposed to Trump is to put aside the psychiatric jargon. Instead of even accidentally hurting our brothers and sisters struggling with mental illness, let’s deploy the incredibly wide wealth of words that accurately describe Trump, his allies, and the threats they pose to American decency and well-being. And there are so many, many words! Cruel. Erratic. Impractical. Thin-skinned. Irrational. Careless. Feel free to use the comments section below to build our anti-Trump thesaurus and let’s shower the opposition with our vast vocabulary.