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The Art of High-Stakes Psychological Diagnosis Pt 1

How to shop among interpretations for peoples’ disturbing behavior

In medicine, a misdiagnosis can kill. In social relationships, a misdiagnosis can kill chances of improvement.

Like many, I’ve been trying to explain how Trump won. I’m working to avoid misdiagnoses because it matters more than ever that we get it right. It’s acceptable to misdiagnose when the stakes are low and the paths to survival are many. That’s not the case here.

And it’s not the case in situations you probably encounter in your everyday life. For example, if you misdiagnose your boss when a job that you desperately need is on the line you will pay way more than you can afford. Misdiagnose your child or partner when there’s a lot at stake and you can mess things up a lot. Misdiagnose your child’s cancer and the child may die leaving you traumatized for life. Misdiagnose your child’s behavior and you can end up likewise traumatized. With cancer, there are experts to rely upon. It’s harder with behavioral problems. Way too many experts guessing at way too many possible explanations. You have to shop among the interpretations carefully.

So I’ll use Trump here as an example of what we all have to deal with in shopping for interpretations whenever the stakes are high.

Trump’s win was what scientists call “overdetermined,” meaning that there are many more possible explanations than necessary. Any one explanation would be sufficient to explain it. To list just a few:

Hillary Clinton was arrogant, an insider, a woman, a weak campaigner, too nice, too focused on inclusivity, not focused enough on the economy, too insensitive to the needs of the the desperate white working class and more of the same, when historically, two- term presidents are always followed by something different.

Trump was the stronger leader, the deliverer of a clearer vision, a better liar, panderer, salesman, showman, more of a straight-talker and backed by Putin, Comey at the FBI, and Julian Assange.

People who voted for Trump were overly represented by the electoral college, fed up with the establishment and gridlock, idiots who think this is a game show, suckers for dictatorship, loyal to their party more than to our country’s future, racist, sexist, fascist, one-issue voters, sheeple, impulse shoppers, living in their own echo chamber, frustrated and flailing, principled, unprincipled, whiners, self-proclaimed winners who just want to be on the winning side, and committed/addicted to the Fox news interpretation of reality.

The list goes on, and my guess is that I’m going to hear from folks who are going to tell me with high confidence which of these is the real explanation. My point here is that there are many to choose from, each of which could explain the win, and that how we choose makes a difference in what we do about it.

Chances are, as you read this list you had some emotional reactions. Some of the explanations were attractive and others were repulsive. You could probably supply reasons why you had those gut reactions. Still, it’s hard to know which came first, the gut reaction or the reasons. That’s the difference between rationality and rationalization. Rationality is having reasons that your gut reaction then follows or represents. Rationalization is gut first, explanation made up afterwards.

If, after the election, you thought you knew right away how to explain it, there’s a good chance your gut was leading. If you doubted that it was that simple and can make the case for each of the possible explanations, chances are that you were being more rational about it, not just rationalizing whatever your gut felt.

I’ll give you an example. Here’s an explanation that I find repulsive; I’m going to make a strong case for it anyway.

Trump is the right guy for our times and voters intuited it. We’re entering a new era in which the US can no longer singlehandedly play policeman to the world and we need much stronger policemen, which means a higher degree of ruthlessness and collaboration in the policing. Some people are repulsed by the ruthlessness, but they just don’t understand. You need superpowers to keep our reckless world in line. Trump recognized this and was as ruthless as necessary to become a leader. He aligned with Russian strongman Putin and will align with other such leaders. Together they will restore global order. Those who were squeamish about Trump’s ruthlessness will be surprised and humbled. They’ll realize that in the long run, ruthless leaders working together will make the world safer and freer. Yes, there will be bloodbaths along the way, but that’s what it takes sometimes. It wouldn’t be the first time that bold leaders took big risks to make the world a better place. And the wisdom of the crowds is powerful and wise enough to bring about such leadership, because in our hearts we know its necessary.

I could do that with each of the diagnoses listed and any others suggested – no matter how credible or bogus they feel to my gut. Being able to do that is a good antidote to rationalizing. It floodlights the range of solutions instead of spotlighting the favored ones.

In Part 2 I’m going to play with a particular diagnosis that interests me. I’m not saying it explains it all or even that it’s right. It’s just my best bet these days as I shop among interpretations. I’ll lay it out at two levels, the symptoms and their origins in voter’s motivations. I’ll show how both can influence what you do in response.

To give a preview and bring it back home, suppose you have a boss who drives you crazy. You can describe the behaviors that drive you crazy. And you can guess at what motivates those behaviors. At both levels you have to be very careful how you diagnose, because if you misdiagnose you’ll be ineffective or counterproductive in dealing with it.