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When I asked her if fasting was a regular part of her dietary regimen, she said, “I’ve fasted a few times before for various reasons. On this occasion, I wanted to think through the direction of my life.”
The trajectory of Lee’s life had indeed taken a strange turn of late. A widely respected scholar who has authored over 100 peer-reviewed articles and either written or edited a dozen academic books on violence, Lee was an assistant clinical professor in the law and psychiatry department at Yale for 17 years until the summer of 2020, when Yale declined to renew her contract. The precipitating offense? Tweeting about the retired Harvard law professor Alan Dershowitz.
Lee claims it was all Dershowitz’s doing: “Dershowitz’s pressure seems to be the reason why everything changed.” But Lee had long been one of her department’s most controversial members, thanks to her outspoken, boundary-pushing commentary about Donald Trump. Still, while her department chair, John Krystal, had never liked the public attention her comments attracted, he had tolerated them as long as she made it clear that she was not speaking on behalf of the department. As he noted in a 2018 talk: “We are an academic institution which respects free speech, but the department and the medical school do not issue statements regarding the mental status of public officials. We are committed to living with this tension.”
Lee has always been driven, she says, by a “sense of social mission,” reflected in her years of work on violence prevention. She strongly identifies with Greta Thunberg and other social-justice advocates. But Lee paid little attention to domestic politics until 2016. “The morning after Trump was elected president, I decided to do something because I was convinced that his administration was likely to increase violence,” she said. The following spring, Lee organized a conference at Yale titled “Does Professional Responsibility Include a Duty to Warn?” on the subject of Trump’s mental state and the ethics of psychiatrists diagnosing him from afar. She respected the Goldwater Rule — the ethical guideline designed to prevent psychiatrists from rendering a professional opinion of a public figure without first receiving permission and conducting an examination — but she also worried about “the risk of remaining silent.”
The conference led to a 2017 book, The Dangerous Case of Donald Trump, which argued that Trump’s lack of “mental fitness” made him a threat to the nation. As Lee and Harvard Medical School psychiatrist Judith Herman put it in their introduction: “Delusional levels of grandiosity, impulsivity, and the compulsions of mental impairment, when combined with an authoritarian cult of personality and a contempt for the rule of law, are a toxic mix.” With contributions from 27 mental-health experts, the book, which sold more than 100,000 copies, claims that Trump likely suffers from a grave personality disorder such as malignant narcissism. Lee then began writing op-eds and emerged as a nationally prominent Trump critic. Being a Trump critic at Yale was not unusual, of course, but what raised eyebrows was the assertion that her critique had the weight of medical expertise behind it.
On January 2, 2020, Lee posted a few tweets about a comment that Dershowitz had made in response to an accusation by one of Jeffrey Epstein’s victims that Epstein had forced her to have sex with Dershowitz. “I have a perfect, perfect sex life,” he had told Fox News. For Lee, Dershowitz’s “odd use of ‘perfect’” called to mind Trump’s phrase “perfect phone call” when describing his infamous interactions with Ukrainian president Volodymyr Zelensky, which led to Trump’s impeachment. This coincidence, she argued on Twitter, “might be dismissed as ordinary influence in most contexts. However, given the severity and spread of ‘shared psychosis’ among just about all of Donald Trump’s followers, a different scenario is more likely … That he has wholly taken on Trump’s symptoms by contagion.”
Dershowitz was enraged. “I was trying to emphasize that I have been faithful to my wife — that I have had perfect attendance in the marriage bed,” he told me. On January 11, Dershowitz fired off a typo-strewn five-sentence email to several top Yale officials, in which he accused Lee of breaking the Goldwater Rule by publicly diagnosing him as psychotic. Dershowitz, who two weeks later would testify on behalf of Trump at his first impeachment trial, claimed that Lee’s comments were motivated by her objections to his political views. “By this email,” wrote Dershowitz, who graduated from Yale Law School in 1962, he was “formally asking Yale university and it’s [sic] medical school to determine whether Dr Lee violated any of its rules.”
Lee was copied on Dershowitz’s email, but didn’t give the matter much thought. Krystal “had received numerous complaints about my public comments on the mental health of Trump and his supporters, which he typically ignored,” she told me. Moreover, by using the term “shared psychosis,” she argued, she was “not diagnosing Dershowitz as ‘psychotic,’ but mentioning a common psychiatric phenomenon in which several people share the same delusion.”
After Dershowitz’s message, however, Krystal adopted a tougher approach. The following Monday morning, he sent Lee an email excoriating “the recklessness of your comments,” which “creates the appearance that they are self-serving in relation to your personal political beliefs and other possible personal aspirations.” He insisted on discussing the matter with her in person a few days later.
When Krystal arrived at his office that Friday, Lee faced him and three other senior administrators in the psychiatry department. “I was surprised because I thought I was going to be speaking just with Krystal. And this discussion was essentially a cross-examination,” recalled Lee. “For example, Krystal kept insisting, ‘You mean shared psychosis is not psychosis?’ And I kept trying to explain that there was in fact a big difference between the two concepts.”
Krystal and his colleagues had a very different take on the meeting. “Dr. Lee’s responses,” Karen Peart, Yale’s director of public relations, informed me in an email, “convinced the committee that she lacked the capacity” to teach the “core competencies of medical knowledge, interpersonal and communication skills, and professionalism. The committee concluded that it was not appropriate for Dr. Lee to have a renewed teaching role in the Department of Psychiatry.” Lee was immediately relieved of various departmental responsibilities, and the law school stopped referring cases to her. That May, Krystal sent her a three-sentence letter informing her that her Yale faculty appointment would end on June 30.
Lee was shocked. “Long-term appointments like mine are typically renewed for life,” she said. “I know of no one in a similar position who has suddenly been asked to leave the university.”
In March of 2021, Lee sued Yale in federal court, arguing that she “was unlawfully terminated from her faculty appointment,” in violation of her “free speech rights, as well as in violation of her right to academic freedom, and other rights contained within Yale’s Faculty Handbook.” The case is focused on the question of speech, but the broader controversy, which is playing out both in the courts and in the academic public square, involves conflicting interpretations of the Goldwater Rule, which itself has long been controversial.
Krystal declined to be interviewed for this article, but in a letter to Lee sent in September of 2020, he claimed that she was fired primarily due to her “repeated violations” of the Goldwater Rule, which he called “a crucial ethical and legal principle in psychiatry.” Even if we accept Krystal’s contention that Lee offered formal psychiatric diagnoses of Trump and Dershowitz — a charge she denies — his insistence that she clearly deserved punishment is debatable.
The rule has its roots in a public humiliation that the American Psychiatric Association suffered over a half century ago. Shortly before the 1964 presidential election between Barry Goldwater and Lyndon Johnson, Fact magazine ran an article entitled “Goldwater: The Man and the Menace.” In 38 pages of comments by APA members, the Republican nominee was judged to suffer from psychiatric conditions ranging from having an “anal character” to being “a dangerous lunatic.” Goldwater successfully sued Fact for libel, and in 1973, the APA added the Goldwater Rule to its code of ethics.
Jerome Kroll, a retired professor of psychiatry at the University of Minnesota, argues that the rule should be abolished. Its “real purpose,” he wrote in a 2016 paper, “is to prevent individual psychiatrists from misrepresenting or embarrassing the psychiatric profession, possibly at the expense of personal, professional, or social values.” Judith Herman, a distinguished life fellow of the APA, notes that psychiatrists are often sanctioned for other ethical violations such as sexually exploiting a patient, “but to my knowledge, the APA has never disciplined anyone for violating the Goldwater Rule.” Another critic, Leonard Glass, resigned from the APA in 2017 after 41 years because he believes the rule has been exploited to silence conscience-driven psychiatrists. (Lee herself resigned in 2007. “I felt this trade association was too beholden to the drug companies,” she said.)
John Martin-Joy, the author of a comprehensive history of the Goldwater Rule called Diagnosing from a Distance, notes that psychiatrists are often asked to assess patients without conducting a personal interview. “Take the case of a psychiatrist who sees a patient in the ER after a suicide attempt and has to rely exclusively on the medical record,” he said. “The APA doesn’t see this as a problem, so the strict limits it has set on what psychiatrists can say about public figures involve a contradiction.”
But numerous influential psychiatrists besides Krystal are fervent supporters of the Goldwater Rule. In a letter published in the New England Journal of Medicine, Columbia’s Jeffrey Lieberman, a past president of the APA, stressed that “more than any other medical specialty, psychiatry is vulnerable to being exploited for partisan political purposes.” In violating the rule, Lee and her co-authors, he concluded, were advocating “a misguided and dangerous morality.”
In a 2017 paper defending the rule, Columbia’s Paul Applebaum, also a past president of the APA, argued that it prevents “essentially worthless” diagnostic conclusions. When I asked him whether psychiatrists have a duty to warn the public about a potentially dangerous leader, Applebaum said, “Even in the case of Hitler, it’s not clear to me what unique knowledge they could have added. Psychiatrists would simply have echoed the conclusions of journalists or public intellectuals.”
The conflict between Krystal and Lee appears to revolve around more than just the Goldwater Rule. Krystal, who graduated from Yale Medical School a decade before Lee, was also initially drawn to psychiatry to help right wrongs. In a speech to the Jewish Federation of Greater New Haven several years ago, he spoke of his admiration for his father, Henry Krystal, a Polish Jew who was shipped off to Auschwitz as a teenager and later became a professor of psychiatry at Michigan State University. Steeped in Freud and the art of psychotherapy, Henry Krystal, who died in 2015, helped shape our current understanding of post-traumatic stress disorder.
John Krystal started out working alongside his father in the field of traumatic stress. Like most academic psychiatrists of his generation, however, he ended up rejecting nearly all psychoanalytic ideas. He became an expert in the chemical neurotransmitters that course through the brain, and for the past 15 years, he has edited Biological Psychiatry, a journal that focuses on translating neuroscience into drug development. For biological psychiatrists like Krystal, the scholarly literature on personality disorders consists mostly of theoretical speculation rather than hard science.
In contrast, Lee’s work — including her various writings on Trump — has been deeply influenced by the Freudian psychiatrists of yesteryear who studied the mind rather than the brain.
Those disagreements are unlikely to be aired in court, even as they take center stage in the debates between Krystal and Lee’s colleagues in the field of mental health. Yale’s argument in the case is that, though all its professors have the freedom to express their views, the university also has the academic freedom to decide which professors to retain. Several professors I spoke to seemed skeptical of the school’s claim.
“A university does have the right to fire someone whose work is substandard,” Laurence Tribe, a Harvard Law professor and constitutional scholar, told me. “But it is hypocritical for Yale to punish Lee simply for criticizing a couple of powerful people — namely, Trump and Dershowitz. That endangers the whole academic enterprise. Lee has a strong case.”
Lee’s lawyer, Robin Kallor, concedes that private universities, unlike public universities, are not necessarily bound by the First Amendment. “But Lee was protected by a Connecticut statute that prohibits retaliation through discipline or discharge for exercising speech rights protected by the U.S. Constitution and Connecticut Constitution,” she said.
Richard Painter of the University of Minnesota, who served as George W. Bush’s ethics counsel, says that non-tenured faculty like Lee are employees at will and can be terminated at any time under contract law, but that “universities do make exceptions and academic freedom is one of those exceptions. And Yale took a very strong stand on academic freedom in its Woodward report, which remains in its faculty handbook.”
In 1974, a committee led by the historian C. Vann Woodward examined the university’s approach toward freedom of speech. The precipitating cause was an incident in which William Shockley, the Nobel prize-winning physicist, was booed off the stage by Yale students as he was about to give a talk on the “I.Q. inferiority” of Blacks. The Woodward report begins with a section on values written by the late Yale political theorist Robert Dahl, which stresses that a university cannot fulfill its primary function unless there is a free exchange of ideas. As Dahl put it in his often quoted words, scholars need “the right to think the unthinkable, discuss the unmentionable, and challenge the unchallengeable….Every official of the university, moreover, has a special obligation to foster free expression and to ensure that it is not obstructed.”
The spirit of the Woodward report has more commonly been invoked to defend controversial speakers, like Bell Curve author Charles Murray, who have been deplatformed by activists students — a stand against cancel culture and the like. Lee’s defenders, a group that includes luminaries like Painter, Noam Chomsky, Cornel West, and Jeffrey Sachs, say the case reveals the hypocrisy of supposed free speech warriors on the right. “Yale made a serious mistake,” said Sachs. “She has taken an appropriate position within the boundaries of academic speech. Academics need to be able to speak out without fear of retribution.”
Gregory Scholtz, director of the Department of Academic Freedom, Tenure, and Governance at the American Association of University Professors, insists that Lee’s tweets constituted protected speech. “Lee is a celebrity,” he told me, “and she was speaking extra-murally — not as a teacher or as a researcher. That is not uncommon, and universities rarely take extra-mural utterances into account when evaluating a professor’s professional fitness.” In September 2020, he wrote a four-page letter to Yale President Peter Salovey defending Lee. He never got a response.
Many of Lee’s supporters note that Dershowitz himself has long prided himself on being a free speech advocate; his most recent book is Cancel Culture: The Latest Attack on Free Speech and Due Process. David Boies, who has faced off against him in a series of cases involving Jeffrey Epstein’s victims, told me, “Dershowitz has repeatedly used inflammatory language to try to derail the careers of scholars who disagree with him.” He pointed to the example of Norman Finkelstein, a political scientist critical of the Israeli government who was denied tenure by DePaul University in 2007 after numerous broadsides from Dershowitz.
“He is a bully who has threatened just about every person or news organization that has alluded to his numerous ties to Epstein,” Boies continued. “His attack on Lee was just another PR stunt. It was an act of intimidation designed to silence his opponents by saying, ‘I will go after you and your financial well-being.’” (Boies, it should be noted, is no stranger to being accused of bullying, having represented Harvey Weinstein as the former Hollywood mogul tried to silence women who had accused him of harassment and assault.)
Dershowitz told me that he is not in fact particularly litigious and had compelling reasons for filing an $80 million defamation lawsuit against Netflix for its portrayal of him in its Epstein documentary. He also denied any malicious intent toward Lee. “I simply provided Yale with some important information that I felt they should know about,” he said.
As the case proceeds, Lee has been forced to move on. A few months ago, she accepted an offer to co-found an institute on violence prevention at Union Theological Center in New York City, where she will be teaching a class this spring. Nevertheless, she still hopes to be reinstated by Yale. “It’s the right thing to do,” she said. “The Yale that I loved — that I dedicated my career to — stood for the principles of justice and truth, and I have not given up on Yale.”
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