Presidents and Psychotherapists

What politicians aren't saying about mental health

Posted Feb 12, 2016

With election season firmly underway, the barbs between those-who-would-be-president are, predictably, heating up. The latest round of trash talking between GOP contenders Donald Trump and Jeb Bush has particularly focused on the other's mental health, if in an entirely juvenile sort of way. This, unfortunately, is the most common format in which mental health is referenced in casual conversation, from "that's insane!" when talking about something surprising to "she's crazy" when talking about a person who may be suffering from a lack of self-awareness. Or what about "her boyfriend went totally psychotic" to describe a person who perhaps overreacted? I heard that one while waiting in line for a latte just the other day.

Using these terms in such an off the cuff manner is unhelpful at best, disrespectful and hurtful at worst. But when it comes from those in the spotlight -- our potential leaders, no less -- the ramifications are even more serious. When Donald Trump described Jeb Bush as "a sad person who has gone absolutely crazy," he did not mean Bush went literally crazy -- but he did mean it to be an insult. But, then, the day before, Bush had taken what was meant to be a shot at Trump with the comment, "The guy needs therapy."

You know what? He probably does. In fact, most of us do.

And yet that, too, was meant to be a dig and, ultimately, a reason not to vote for Trump. As if there's something wrong with therapy. As if pursuing mental health should make a political candidate less desirable.

Although: Does it?

Few politicians have copped to having enlisted a therapist -- not even presidents, who arguably have one of the most, if not the most, stressful jobs in the world. There's but a handful: Former Florida governor Lawton Chiles, who disclosed his use of Prozac for depression; current Minnesota governor Mark Dayton, who has discussed his struggles with depression and alcoholism; Rhode Island representative Patrick Kennedy, who is bipolar. Former U.S. Representative Anthony Weiner has openly talked about his experience in therapy, though only in the context of his "recovery PR." And, of course, President Richard Nixon had a psychotherapist, but that fact wasn't revealed until many years later. Beyond that, political leaders see pastors and priests, counselors and advisers, but not professionals who specialize in mental wellness -- unless they do, and they just don't want to cop to it. With good reason: As the media fury around the admissions of both Chiles and Dayton -- as well as colleagues like Doug Duncan, whose clinical depression caused him to drop out of the race for Maryland governor in 2006 -- show, it's not an easy admission to make.

This says a lot about the view of mental illness in this country. Politicians can talk all they want about the importance of mental health reform, no matter what their particular agenda regarding it, but addressing their own emotional and psychological needs would go a long way towards reducing the stigma that prevents many American citizens from recognizing their own illness or seeking treatment. Why should talking about mental health be an "admission" at all?

That's not to say all politicians are in treatment and hiding their therapists -- just that it seems hard to believe that there's no one in American politics who utilizes mental health resources, especially given that politicians fit into psychotherapy's exact demo, which has been growing steadily. A 2010 study published in the American Journal of Psychiatry reported that the number of people seeking outpatient services has increased year after year. Meanwhile, studies also show that people with higher levels of education and more income have a greater acceptance of psychology, and that those with a college education were twice as likely to use psychotherapy than those without.

It's easy to see why it might be a good idea for politicians to keep their relationship with therapy to themselves, given the enduring misunderstandings of, and stigma attached to, mental illness. Most people simply aren't ready to elect a leader with mental illness, or even the suggestion of one. But mental illness takes many forms. So does mental health. The stigma surrounding prevention and treatment needs to change, for a number of reasons. Hearing a leader talk about his or her experience with mental health care isn't the answer, but it would certainly be a very good start.

Peggy Drexler, Ph.D. is a research psychologist, Assistant Professor of Psychology at Weill Medical College, Cornell University and author of two books about modern families and the children they produce. Follow Peggy on Twitter and Facebook and learn more about Peggy at