Executive Function: Does America Have a Judgment Problem?

Source: Adobe stock image by dizain, licensed by Ravi Chandra

While most of us are understandably watching the horse race between President Biden and former President Trump, as a psychiatrist and concerned citizen, I remain alarmed that we don’t seem to have a functional means of assessing any potential leader’s capacity to do the job. Of course, in a democracy (or democratic republic), we must leave it up to voters or their elected intermediaries to come to terms on issues of importance, but as psychologist Adam Grant and others, including Psychology Today's Dr. Gail Sahar have noted (see references), as human beings, we tend to "escalate commitment to a losing cause," double down and stay the course, full steam ahead, damn the torpedoes, throw good money after bad, etc., when faced with setbacks or naysaying. We all might have confirmation biases and cognitive rigidity–and these are not great signs of a healthy, flexible democracy or psyche. On the other hand, perseverance, even stubbornness, in the face of long odds is an admirable trait. But when does this turn into selfish insistence and denial?

As I've noted many times, it's more important to be related than "right," and we have to be able to take into account others' opinions of us as well as objective data about our performance. Many other jobs require some kind of evaluation for fitness for duty. Even psychoanalysts, for example, are required to sit for cognitive evaluation every ten years. But with the highest office in the land, we essentially submit to the will of the duly-elected leader and their team, and to their capacity to assess themselves and listen to others who dare “speak truth to power.” At worst, we rely on opinion, popularity, and electability rather than having rational decision-making processes based on reality.

The current era may, in fact, be a "reality crisis," in which only assertions, perceptions, assumptions, emotion, authority, and ideology matter, rather than substance and fact. Isn't it time to stop the slide?

Let's face it: It’s a rare leader who will even admit they have a potential problem. As humans, we all have a tendency to hide or downplay issues, or even be completely unconscious of data and views that don't validate our perspectives. It’s a rare leader indeed who steps aside or voluntarily submits to objective evaluation for cognition, character, and leadership qualities. We certainly do not require these evaluations. While none of them are perfect, they could provide the leader, his team, and the voters with salient information to make their choices.

We also do not require leaders who really listen to and consider opposing viewpoints.

I have no idea who will win the election in November. Polls have been shown to be methodologically flawed. Jay Kuo noted on his Substack that polls tend to overweight conservative voters and underweight minorities. Most recently, Kuo and others have noted polls "are still showing a tied race and less movement than normally occurs after a bad debate performance." Clearly, voter engagement and get-out-the-vote (GOTV) drives will be essential for all parties. We also do not know what the impact of disinformation will be upon our collective synapses. We don’t know what the impact of events between now and November 5, 2024, will be.

Most importantly, the reliance on polling supports a top-down, hierarchical decision-making process that is dependent on public perceptions of performance and electability, rather than objective, reality-based assessments of actual capacity, competence, and fitness to do the job. Hopefully, the "job" is not simply "to get elected!"

The New York Times editorial board just issued a 4,300-word declaration that former President Donald Trump is unfit for the office of president. Two weeks ago, after his debate performance raised anxieties, they proclaimed that President Biden should step aside "to serve his country." In both editorials, they had no objective scientific data, but affirmed that journalism is the authority. The Times, and media in general, ignored expert psychiatric opinion on Donald Trump in the past, and the Times left out any evaluation of Mr. Trump's cognition in this most recent op-ed.

Wouldn’t it be a great relief for all of us if the leader of the free world would acknowledge that there is at least a problem of perceptions—if not a problem of his will? Would it not be important to set an example by undergoing evaluation and using this information privately, at the very least, to make an informed decision about whether to seek the nomination?

We are talking a lot about shoring up democracy, and there’s great fear about the power of the executive branch and the erosion of our system of checks and balances. There are psychological principles of democracy that are at stake. They have not been upheld throughout our history, of course, but without an attempt to do better, where are we? The most fundamental of these is that we do not have a monarchy, but a democratic republic.

The question before us really is: what do we want in a leader, and their team? What is our vision for strength, self-awareness, self-regulation, empathy, selflessness, ability to admit vulnerability, and ability to listen to counterpoints? What would a truly democratic commander-in-chief look like—less insistent on his authority and primacy, and more interested in the good of the country and its deepest principles and virtues? Is there any check or balance on the leaders' presumptions about his capacity and fitness?

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This question for the ages will not be resolved in this election cycle, but is one which we must consider.

© 2024 Ravi Chandra, M.D., D.F.A.P.A.