Steven Pinker, a Canadian psychologist and longtime faculty member at Harvard, reflected this week in a NYT op-ed on what he is terming ‘Harvard Derangement Syndrome’. The university, one of many lightening rods for the Trump administration, has drawn multiple ‘strikes’ — first for refusing to take a knee to the ‘modest proposal’ that they cede administrative oversight, admission policies, nominal presidency, DEI mandates, and a whole truck load of other demands. . . by the current Whitehouse autocrat. After the dictum was withdrawn (oopsie, must have been sent in error!), Harvard’s tax exempt status was to be removed, again on executive instruction to the IRS — don’t get Elizabeth Warren started on that one! And now an attempt to block all international student attendance, which, if it hadn’t been stayed, would have gone a good way toward gutting fiscal viability and academic excellence at the institution. 

After detailing Harvard’s manifest ‘warts and all’, Pinker goes on to plead his case for a ‘sense of proportionality’ and temperance when dealing not with just institutions, but all the other targets of ‘waste, fraud, and abuse’ (as the current catch phrase goes!) — aka, DOGE’s slash and burn approach to implementing the administration’s whim. 

Early in his piece, Pinker makes reference to a symptom, oh so familiar to mental health practitioners, that resonated with this one in particular: ‘splitting’. Anyone with even a passing brush with CBT (cognitive behavioural therapy), will recognize what has for nigh on 75 years been viewed as ‘black or white’ ‘all or none’ views of the world. In Pinker’s words, a world populated by ‘exalted angels’ or ‘odious evildoers’. In those of CBT’s patriarch, Albert Ellis, irrational thought.

I was (once again) reminded of a collection of essays published shortly after the beginning of Trump’s first term, called The Dangerous Case of Donald Trump. Contributions from academics and clinicians, psychologists and psychiatrists — all very careful to avoid ‘diagnosing’ the new president; but offering up thoughts on what various and sundry disorders, syndromes might be descriptive — were he to be assessed and diagnosed. The twenty plus articles float narcissism, dementia, antisocial personality, sociopathy, or just flat ‘crazy’ as considerations. 

I’ve been asked too many times to count, variations on the same question: ‘So. . . what is he?’ I typically ‘plead the 5th’ — but can’t resist the temptation to speculate. . .even if only privately! Pinker’s piece raised another question: Is there a dysfunctional, administrative style underpinning not just Trump. . . but Project 2025 as a game plan? Is there an institutional personality? One that so informs its governance and so reflects the characteristics of its chief, that it goes far beyond a ‘split view of the world’ all the way to borderline behaviour? 

So with the proviso that this is not a diagnosis. . . but only a ‘compare and contrast’ exercise between traits and styles associated with borderline behaviour and the parallels with administrative proclivities. . .

Just sayin’. . . to riff on OJ — if the glove fits.

‘So what’s on top today?’ One of multiple ‘openers’ to appointments that I’ve test-driven over the years. All, in one way or another, attempts at cutting to the chase, skipping over the usual ice breakers of weather, the most recent episode of ________ (fill in the blank, depending on decade), news headlines. . . etc. After a thoughtful pause, the responses are often a variation on ‘been a tough week’. ‘Could you say a bit more about. . .’ an effort at putting a bit more flesh on these bones. As frequently as not, this summons up a statement of general malaise — aka, unhappiness.

With the release of the 2025 World Happiness report in recent weeks, I wasn’t surprised to see a number of op eds focussed on the topic. Now, without looking, of the 147 countries tapped, who would you expect to top the polls? Yep, once again from the 2024 data, those bastions of ice, snow, and reduced hours of daily sunlight, occupy 5 of the top 10 spots. Finland (darkest of all??) bumps that perennial home to the smiley face emoji (Denmark) down to number 2 — but hot on its heels (as it were) were Iceland, Sweden, and Norway. 

Recognizing that happiness is both an ephemeral and complex concept, the Report uses a deceptively simple strategy (Cantril’s Ladder):

• • Imagine a ladder with 10 rungs
  • The top rung represents the best possible life for you; the bottom step, the worst possible life
  • On which step of the ladder would you say your personally feel stand at this time

From the 150,000 or so annual responses and over its dozen years of study, the Report has generated six determinants of happiness that account for most (75%) of the variance — which is just an (overly complicated) way of saying: Here’s what matters most!

• • Having someone to count on
  • GDP per capita 
  • Healthy Life Expectancy
  • Freedom to make life choices
  • Generosity
  • Freedom from corruption

Ipso facto, our Nordic quintette ticks many of these underpinning boxes. 

This year’s Report has spotlighted a particular obsession of mine (and not just because of the title!): Connection. E.M. Forster’s classic, Howard’s End has as the book’s epithet Only Connect. Whether an imperative, life-advice, or just a friendly suggestion to Henry Wilcox to ‘chill’, this appears to be high up on the list of happiness correlates. Vivek Murthy, Obama’s Surgeon General, made, as a key element in his term, addressing loneliness and isolation. His book, Together made the point in it’s subtitle: ‘The Healing Power of Human Connection in a Sometimes Lonely World’. 

The Report’s chapter titles pretty much capture it all:

Closer to the psychological barn, Martin Seligman proposes the following as the ‘happiness equation’ (in Authentic Happiness)

H = S + C + V

where H (enduring happiness) depends on:

• • factors out of our control (S) — about 50% of the result

• • external circumstances (C) — contributing about 10-15%
    • • living in a democracy vs. a dictatorship / autocracy
      • being married or in a stable relationship
      • having a robust social network
      • avoiding negative events / emotions
      • having a religious connection

• • voluntary, controllable factors (V) — about 40%
    • positive emotions about the past (satisfaction, contentment, fulfillment, serenity)
    • positive emotions about the future (optimism, hope, faith, trust)
    • positive emotions about the present (calm, pleasure, flow).

So in a polarized, partisan, pugnacious culture, it may make some sense to focus on the C’s (best we can) and the V’s — or, at least, sitting in a sauna with a happy Finn. 

Sitting in a small, over-bright seminar room on the sixth floor of Western’s Social Sciences complex with five classmates, I bit the side of my index finger to hold focus. The topic — actuarial versus clinical approaches to assessment — may not sound compelling or prescient, but. . . Harvey, Dr. Doug’s teaching assistant was making a strong, if not riveting case for the former. It was the early ’70’s and computers were still finding their footing in the hallowed halls of learning. AI. . . well, just a sci-fi concept (or a steak sauce, if you’re a secretary of education). Hal (Heuristically programmed Algorithmic computer) had barely had time to go rogue and over-ride Dave’s request to ‘open the pod door’ — all in aid of protecting itself from human meddling. And we six were a hard sell for Harvey’s pitch favouring factor analysis over human instinct and intuition. 

Fast forward a half-century (OMG, has it really been that long!) Hal may have been sold for parts, Orange (Agent, Clockwork, or otherwise) has replaced Hal’s penetrating red eye with less than penetrating red hats, and the humourless, automated, monotonic (some would say, moronic) voice now issues assaultingly from a guy obsessed with the red planet and bad math. But it seems the arm wrestle between the human and the machine carries on.

I have to fess up — I use tests! Paper and pencil, increasingly digitally administered measures of personality, interest, intelligence, aptitude. Rorschachs, projectives — not so much. Fun at a party, but, well, a bit too close to tea leaves and phrenology for my taste. Still there’s nothing like a good, big pile of psychometric data to flesh out a report and lend a little gravitas to one’s ‘clinical impression’. (Dr. Doug would be rolling over at the mere mention of something as ephemeral as ‘an impression’!) And while we’re in confession mode, report writing is a whole lot less onerous with machine scored results and oft-used (dare I say ‘canned’) boiler plate phraseology. 

Enter AI. Slipping in noiselessly on little cat feet, summarizing sessions, prepping proposed overviews of appointments, ‘freeing’ practitioners to concentrate on the client (vs. finding a pen that writes), and obviating the cognitive log jam as the therapist struggles to remember what was talked about — an hour (or a day, or heaven forfend, a week) later. All with the disclaimer, of course, that ‘AI-generated content may be inaccurate or misleading. Always check for accuracy.’ Even AI has to enlist a little CYA’ing. Nevertheless with comforting monikers attached: ‘companion’, ‘assistant’, . .

And then there’s Abby (or Happi or even Eliza — for folks with one or both feet in the past) ‘in your pocket’ and available 24/7 (as the pitch goes), empathic, attentive, supportive (and cheaper!) than those pesky humans. Who wouldn’t opt for the relentless positivity of a less paranoid and clearly more benign Hal!

Finding a best way forward, whether it be in medicine, psychology, truck-driving, or widget manufacturing is presenting as the ethical dilemma. I read an interesting piece in the New Yorker today paralleling the late eighteenth century struggles in the UK textile industry with today’s AI ‘revolution’. In a few short decades, an artisanal population was displaced and decimated by automation and machinery. In its wisdom, the government of the time (an 1800’s equivalent of today’s billionaires boys club) saw fit to criminalize the ‘old ways’ (Frame Breaking Act, 1812), making open resistance to the more profitable ‘industrialized options’ a capital offence. This in favour of finding a sustainable middle ground. One where both the capitalist and the craftsman may coexist, the latter benefiting from innovation; the former incorporating the latter’s wisdom, experience, and skill. I have no wish to sacrifice, to remove from my practice all the benefits that have evolved over the past 50 years. Neither do I want to hang all the mental health practitioners who continue to bring their distinctly human expertise to the table.