On February 13, 2017, thirty-five physicians signed a letter to the New York Times that stated: “We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president.” Even a quick glance at social media or political buttons and bumper stickers shows us that these doctors are not the only ones worried about our current POTUS and the future of our republic. Americans’ current level of concern about the mental health of the man serving in the White House goes beyond what many of us have seen in our lifetimes, but, like all concerns, this one, too has a history.
In this country, anxieties about the mental stability or instability of our leaders can be traced back to the earliest years of the republic. The founding generation worried incessantly about the possibility of irrational actors in a government premised on rationality. In opposition to ratification of the Constitution, George Clinton fretted that it would be difficult to guard against the “unbridled ambition of a bad man, or afford security against negligence, cruelty, or any other defect of mind.” Perhaps Clinton and others from the founding generation were right to worry. Could President Donald Trump be the embodiment of their fears?
As the United States emerged from the American Revolution, Americans agonized about the possible failure of their experiments in government. The new systems that arose during and after the war emphasized the social compact, linking the individual and government explicitly. As the 1780 Massachusetts Constitution stated: “The body-politic is formed by a voluntary association of individuals: it is a social compact, by which the whole people covenants with each citizen, and each citizen with the whole people, that all should be governed by certain laws for the common good.”
This relationship necessitated rationality. In his 1794 medical dissertation on insanity, Edward Cutbrush wrote that “an uninterrupted use” of reason “is absolutely necessary for the well being of all societies, both civil and religious.”1 People needed to be rational enough to understand their positions and occupy them fully according to the norms. Otherwise, they created dangerous situations for themselves, their families, communities, and even the republic. Lunatics, as they were called most frequently in the late 18th century, were incapable of this kind of rationality. For many Americans, fears about lunatics intersected with anxiety over the health of the community and nation.
Americans had a reason to worry as a tendency toward madness came, according to 18th- and 19th-century physicians, from the very freedom Americans cherished. According to the medical texts, in countries ruled by despots, there was no madness. However, where there was access to political and economic power, striving for office, “an increase in the number and magnitude of the objects of ambition and avarice, and the greater joy or distress, which is produced by gratification or disappointments,” insanity was widespread.2
If both equality and opportunity were causes of insanity, Americans were in trouble for they lived in a nation where political participation was increasingly open to the adult white male population and where the economy had been changed by new forms of market interactions. The very conditions of the new republic created tendencies toward madness.
It was not just physicians treating or studying the insane who were concerned. Medical and political theories intersected. The medical theories about insanity worked their way into the halls of politics as we see in a 1785 letter by William Samuel Johnson, serving in the Confederation Congress. He wrote about the possibility of a new tyrannical government rising from the ashes of the old: “The greatest Danger in that regard … seems to arise from that Strong propensity we have to run into … lunacy & dissipations of every kind.” 3
In the immediate aftermath of the American Revolution, Johnson was not the only American who looked around him and worried about the future of the republic. If Americans could not resolve the problems the new country faced, and if Americans were particularly prone to madness, wouldn’t it be easy for a tyrant to step in and lure Americans away from virtue, asserting his authority over them?
In 1789, in the First Congress, as members of the U.S. House of Representatives sought to understand the nature of the checks and balances within their new government, Congressmen debated whether the President should have the power to remove Department heads from office. Insanity played no small part in this debate. Theodore Sedgwick of Massachusetts asked: “Suppose, sir, a man becomes insane by the visitation of God, and is likely to run our affairs; are the hands of government to be confined from warding off the evil?”
While Sedgwick wanted the President to be able to act quickly, Congressman James Jackson of Georgia disagreed. He took the argument further, stating that it was possible that the President might suffer from “an absolute fit of lunacy,” and continued that “although it was improbable that the majority of both houses of Congress may be in that situation, yet is by no means impossible.” 4
Today, as then, there is no sanity test for office, and in addition, a politician might be perfectly rational when he (or now, she) is elected or appointed, but then experience temporary or permanent mental impairment. In 1804, Judge John Pickering provided a clear example of this. Pickering had been a well-respected community leader and had been appointed as the Chief Justice of the New Hampshire Superior Court in 1790.
By 1795, he had begun to demonstrate signs of mental illness, but instead of removing him from office, he was assigned to the less demanding United States District Court and confirmed by the U.S. Senate. By 1800, his mental deterioration was clear to everyone who observed him in court, but there was no clear path to removal from office. He had been a fine, upstanding man, but had become, over the years, a “feeble, aged lunatic.” Was this enough to remove him from office? As Senator William Cocke stated, there was “no law that makes derangement criminal.”5
If someone is elected or appointed to office who is irrational, or if a politician becomes irrational after election, what should be done? The U.S. Constitution does allow for impeachment and removal from office, but only in the cases of “Conviction of, Treason, Bribery, or other high Crimes and Misdemeanors,” and not in cases of insanity.
Unfortunately, my research does not give me an answer to the question of how to remove an erratic and irrational leader from office, particularly not when he was erratic and irrational when elected. Americans have debated the question through our country’s existence. By 1905, an amendment to the Constitution that would have allowed removal of a judge guilty of “immorality, imbecility, maladministration, misfeasance or malfeasance in office,” was proposed and rejected.
In 1967, the Twenty-Fifth Amendment to the U.S. Constitution was adopted, which does include a section that allows the Vice President, together with a majority of other stipulated leaders, to present a written declaration that “the President is unable to discharge the powers and duties of his office,” but the process is unwieldy and unlikely to result in removal.
The founding generation confronted the question of what to do about irrational actors, but could not come up with a clear answer. In a social compact, physical and mental impairment of an individual can injure the body politic. Nevertheless, in a government committed to opposing tyrannical rule, political motivations behind desire for removal have to be closely examined. Determining where the line rests between just and unjust removal from office is an uncomfortable calculus. It was uncomfortable for many of the men who assumed the first mantles of power in the new United States. It is uncomfortable for those of us now who worry about the future of our nation as we wobble on our current course.
The world is a very different place than it was in the early republic, but we find ourselves grappling with some of the same questions the founding generation did. The government that was adopted in 1787 has been amended and revised, but still, at its core, is a social compact based on the necessity of rational actors. Our historical record is strewn with irrational leaders, but we still have no mechanism for dealing with irrationality: irrationality is still not an impeachable offense.
There is no Constitutional answer to the dangers posed by someone who, according to the same doctors quoted above, exhibits traits that “distort reality to suit [his] psychological state, attacking facts and those who convey them.” But, perhaps we can find some small comfort in looking back and uncovering partisanship, pettiness, egotistical behavior, and irrationality in the early republic. The republic survives despite the fact that sometimes (often?) those in positions of power have not been motivated not by love of country, but by “[a]mbition, avarice, personal animosity, [and] party opposition.”
The historical record is filled with Americans who have been convinced, as I am now, that a head of state can be a dangerous demagogue; nevertheless, we have persisted. With our distance, it is easy to contextualize the past; perhaps, now, we can more fully understand the fears of those who lived in that past.
- Edward Cutbrush, An Inaugural Dissertation on Insanity: Submitted to the Examination of the Rev. John Ewing, S.T.P. Provost; The Trustees and Medical Professors of the University of Pennsylvania; for the Degree of Doctor of Medicine, On the Nineteenth Day of May, A.D. MDCCXCIV (Philadelphia: Zacahariah Poulson, Jr., 1794), 5. Return to text.
- Benjamin Rush, Medical Inquiries and Observations upon the Diseases of the Mind, 5th ed. (Philadelphia: Grigg and Elliot, 1835), 64. Return to text.
- William Samuel Johnson to Benjamin Gale, February 2, 1785. Letters to Delegates of Congress, 1774-1789, accessed August 7, 2016. Return to text.
- Jonathan Elliot, ed., Debates in the Several State Conventions on the Adoption of the Federal Constitution as Recommended by the General Convention at Philadelphia in 1787. Together with the Journal of the Federal Convention, Luther Martin’s Letter, Yates’s Minutes, Congressional Opinions, Virginia and Kentucky Resolutions of ’98-’99, and Other Illustrations of the Constitution, Vol 4 (Philadelphia: J.B. Lippincott & Co., 1866), 355, 372. Return to text.
- Lynn W. Turner, “The Impeachment of John Pickering,” American Historical Review 54 (April 1949): 494. Despite the fact that there was not a law that made derangement criminal, Pickering was removed from office on a party-line vote. Return to text.