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New York Times
A Yale Psychiatrist’s Tweet About Dershowitz, Her Dismissal, and a Lawsuit
By Mihir Zaveri
March 26, 2021

In July 2019, Alan M. Dershowitz, the lawyer who defended President Donald J. Trump during Mr. Trump’s first impeachment trial, said in an interview that he had a “perfect sex life” with his wife.

Mr. Dershowitz’s phrasing — in response to questions about his connections to the accused sex trafficker Jeffrey Epstein — drew headlines at the time. The comments also prompted Bandy X. Lee, then a psychiatrist at Yale University who had questioned Mr. Trump’s mental fitness and his influence over his supporters, to assess Mr. Dershowitz’s behavior.

In January 2020, she compared Mr. Dershowitz’s wording with Mr. Trump’s own prominent use of the word “perfect,” suggesting in a tweet that it could reflect a “shared psychosis” through which Mr. Dershowitz had taken on what she said was Mr. Trump’s “grandiosity and delusional-level impunity.”

Days later, Mr. Dershowitz complained in an email to Yale, saying that Dr. Lee had violated ethics rules by offering a public diagnosis without examining him. Shortly after, Dr. Lee says, the head of Yale’s psychiatry department warned her about her behavior.

Dr. Lee eventually lost her position at the school.

In a lawsuit filed this week, Dr. Lee, 50, said she was not reinstated last year to her appointment as a professor in the psychiatry department — for the first time since 2003 — and Mr. Dershowitz’s complaint was part of the reason why.

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She contended that the tweet was not a formal diagnosis, and that Yale’s move violated her First Amendment rights and impinged on her academic freedom.

“My goal currently is to ensure that professionals and intellectuals are not silenced,” Dr. Lee said in an interview.

ImageDr. Bandy X. Lee, whose appointment was not renewed by Yale, said she had “tried to fulfill my societal duty, which is to call out signs of danger, and signs of unfitness.”
Dr. Bandy X. Lee, whose appointment was not renewed by Yale, said she had “tried to fulfill my societal duty, which is to call out signs of danger, and signs of unfitness.”Credit…Nir Arieli
But to Mr. Dershowitz and others, Dr. Lee’s comments displayed a dangerous intermingling of medical opinions with politics. He said he had not communicated with Yale about Dr. Lee since his initial email to the university.

“The idea that you can diagnose me, without ever having even met me, is unprofessional, irresponsible and unacademic,” he said.

The case touches on an intense debate over free speech and decades-old guidelines that govern what psychiatrists like Dr. Lee should be allowed to say in public.

Mr. Dershowitz, a professor emeritus at Harvard Law School who graduated from Yale Law School in 1962, is a longtime criminal defense lawyer known for representing high-profile clients like Mr. Epstein, O.J. Simpson and Mike Tyson. He joined Mr. Trump’s defense team to make constitutional arguments against impeachment. His most recent book, “Cancel Culture: The Latest Attack on Free Speech and Due Process,” was published last year.

Yale did not answer several questions about Dr. Lee and her lawsuit. But in a statement, a spokeswoman for the university, Karen Peart, said Dr. Lee was a “voluntary faculty member” in the medical school and received a faculty affiliation in exchange for up to four hours of teaching per week. Voluntary faculty are not tenured professors.

“Her request for reappointment was considered in accordance with Yale’s policies and practices,” Ms. Peart said. “Yale does not consider the political opinions of faculty members when making appointment decisions.”

In the 1970s, the American Psychiatric Association adopted a rule saying it was unethical for psychiatrists to issue a professional opinion about a public figure’s condition “unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

It was called the Goldwater Rule because it was inspired by a survey of psychiatrists who had weighed in on Barry Goldwater’s fitness for office when he was the Republican candidate for president in 1964. Mr. Goldwater successfully sued the magazine that published the survey.

“Yale does not consider the political opinions of faculty members when making appointment decisions,’’ a Yale spokeswoman said in response to questions about Dr. Lee’s lawsuit.
“Yale does not consider the political opinions of faculty members when making appointment decisions,’’ a Yale spokeswoman said in response to questions about Dr. Lee’s lawsuit.Credit…Michelle Mcloughlin/Reuters
Jeffrey Lieberman, a Columbia University professor who chairs the psychiatry department, said Dr. Lee’s comments about Mr. Dershowitz were “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,” he said.

Others have questioned the relevance of the Goldwater rule. Jonathan Moreno, a bioethics professor at the University of Pennsylvania, said he had not heard of anyone being disciplined by the American Psychiatric Association for violating the rule, even though people repeatedly broke it.

He also said professionals in other medical fields routinely comment in the press about the health of public figures.

During Mr. Trump’s campaign and presidency, his sometimes rambling and incendiary statements led many psychiatrists to publicly suggest that he exhibited a range of personality problems, such as a lack of empathy and “malignant narcissism.”

A representative for Mr. Trump did not respond to a request for comment.

Dr. Lee said she had studied gang leaders and other violent offenders in prison for more than 20 years and noticed similarities between them and what she said was Mr. Trump’s “violent psychology.”

She said she was initially reluctant to speak out publicly, instead raising her concerns privately to members of Congress from both parties. But they told her that mental health professionals needed to educate the public, so she and other psychiatrists began speaking to the news media.

In March 2017, amid a continuing conversation about Mr. Trump’s fitness for office, the association’s president issued a statement reaffirming its commitment to the Goldwater Rule.

In January 2018, the association released another statement saying that “armchair psychiatry or the use of psychiatry as a political tool is the misuse of psychiatry and is unacceptable and unethical.”

Dr. Lee, who said she was not a member of the association, agreed that she could not diagnose anyone without access to their full medical records. But she said she had never made formal diagnoses of Mr. Trump or Mr. Dershowitz and that the association’s position was akin to a “gag order.”

“I have never diagnosed the former president,” she said. “But I have tried to fulfill my societal duty, which is to call out signs of danger, and signs of unfitness. These are of interest to public heath, not to Donald Trump’s personal health, but to the public health.”

The association declined to comment on Dr. Lee’s case. The group would not say whether anyone had been disciplined for breaking the rule, saying violations by a member could result in an ethics investigation and possible punishment, but that those investigations were confidential.

Yale had requested in 2017 that Dr. Lee make clear that her opinions about Mr. Trump were not endorsed by the university, according to the lawsuit. But she said she continued to speak out, including about the danger of “shared psychosis.”

Days after Mr. Dershowitz wrote to the school in January 2020, John Krystal, chairman of Yale’s psychiatry department, sent an email to Dr. Lee, saying that the university would be “compelled” to terminate her teaching role at Yale if she did not change her behavior, according to the lawsuit.

“You are putting me in a position where I have to ask, ‘Is this the sort of person that I can trust to teach medical students, residents, and forensic psychiatry fellows?’” Dr. Krystal wrote in the email, according to the lawsuit.

He soon met with Dr. Lee and said she had breached psychiatric ethics by “diagnosing” Mr. Dershowitz, according to her lawsuit. It’s not clear what other hearings or investigations Yale may have conducted. In May, Yale told Dr. Lee that it was terminating her relationship with the university, according to the lawsuit.

A September letter from Dr. Krystal to Dr. Lee excerpted in the lawsuit indicates that she was let go after a committee determined that her public statements called into question her “clinical judgment and professionalism” to teach trainees. The letter states that her “diagnostic impressions” of Mr. Trump and other public figures played a role in the school’s decisions.

“You did not make these statements as a layperson offering a political judgment; you made them explicitly in your professional capacity as a psychiatrist and on the basis of your psychiatric knowledge and judgment,” Dr. Krystal wrote, according to the lawsuit. “For that reason, the committee decided it was appropriate to consider how these statements reflected your ability to teach trainees.”

The letter then says, “We recognize that without formal teaching responsibilities your appointment could not be reinstated.”