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The armchair psychoanalyzing of Trump stigmatizes and trivializes mental illness, experts warn

The armchair psychoanalyzing of Trump trivializes mental illness
REUTERS/Michelle McLoughlin
Donald Trump speaking during a campaign event in Fairfield, Connecticut, on Saturday.

Not a day goes by, it seems, without somebody speculating in the media about Donald Trump’s mental health.

The Republican Party's presidential nominee has been called, for example, “a textbook narcissist,” “not sane,” “crazy,” a “sociopath,” "simply bananas" and “totally nuts.”

In a recent article in the Atlantic, Dan P. McAdams, a psychologist at Northwestern University, explored Trump’s personality — particularly his “narcissism, disagreeableness and grandiosity” — in lengthy detail. Other psychologists have offered up their opinions as well. George Simon, a psychologist who has written extensively about manipulative behavior, told Vanity Fair that Trump’s narcissistic personality disorder was “so classic that I’m archiving video clips of him to use in workshops because there’s no better example of his characteristics.”

In recent weeks, the armchair psychoanalyzing of Donald Trump has become almost as popular as catching Pokémon — a development that hasn’t escaped the attention of the powers-to-be at the American Psychiatric Association (APA). Earlier this month, Dr. Marie Oquendo, president of the APA, issued a statement in which she reminded her organization’s members of the so-called Goldwater Rule, “which prohibits psychiatrists from offering opinions on someone they have not personally evaluated.”

Breaking that rule, she added, “is irresponsible, potentially stigmatizing, and definitely unethical."

The rule got its name, by the way, during the 1964 presidential election, when more than 1,100 psychiatrists told a survey-taker for Fact magazine that Sen. Barry Goldwater, the GOP nominee that year, was psychologically unfit to be president.

Demeaning to others

A few other voices have also been warning clinicians and others about labeling Trump with a mental disorder.

Patrick J. Kennedy, a former Democratic congressman from Massachusetts and co-author of “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction,” says calling Trump “crazy” demeans people with mental illness.

“‘Crazy’ is never uttered with compassion,” he explains in a recent op-ed for the Washington Post. “I have never heard it used in the context of trying to get someone the treatment they need. When that language is commonplace, it becomes that much harder for those experiencing mental illness to openly seek treatment that works.”

“Believe me, I’m not Trump fan,” he adds. “ … But we can reject Trump without resorting to making baseless diagnoses of his mental health.”

Adding to the stigma

Dr. Susan Molchan, a psychiatrist who practices in metropolitan Washington, D.C., makes a similar point in an article she wrote last week for the Minnesota-based HealthNewsReview website:

As humans, when we see unusual or upsetting behavior, we want to understand it and explain it. When it’s something offensive to us, or is exhibited by someone we don’t like or don’t agree with, we may call that person names.

Given the stigma of mental illness, one variation of name-calling is to say they look “manic,” “bipolar,” have a “personality disorder,” are “mentally unfit,” “unstable,” or “deranged” — all terms that have been hurled at Trump recently. (Some of these also have been used for Hillary Clinton, too, though less often.)

Mental health professionals spend years in training and spend hours interviewing those with problems to discern “a diagnosis,” essentially a label that gives us some idea about what may help an individual.”

“We can’t begin to discern a person’s psyche from a television screen,” she adds. “It’s unprofessional for psychologists or others in the mental health field to comment on a public figure’s ‘diagnosis’ or supposed health problems, and journalists should keep this in mind if any ‘professionals’ offer such opinions.”

Obnoxious, but not ill

In a commentary for the Huffington Post, Dr. Allen Frances, professor emeritus of psychiatry at Duke University, adds another wrinkle to these warnings.  The two leading armchair opinions about Trump’s psychological health — that he has either a narcissistic personality disorder or a borderline personality disorder — are not just “inappropriate” and “troubling,” he says, but also “inaccurate.”

Writes Frances:

Trump obviously does have an outsized, obnoxious personality, but most certainly does not have a Personality Disorder (and there is no evidence that he has now, or ever has had, any other mental disorder). Personality Disorder requires that the individual’s personality characteristics causes clinically significant distress or impairment. Trump’s behavior causes a great deal of significant distress and impairment in others, but he seems singularly undistressed and his obnoxiousness has been richly rewarded, not a source of impairment.

This does not make Trump fit to be president, not by any means. He must be by far the least suitable person ever to run for high office in the US — completely disqualified by habitual dishonesty, bullying, bravado, bloviating ignorance, blustery braggadocio, angry vengefulness, petty pique, impulsive unpredictability, tyrannical temper, fiscal irresponsibility, imperial ambitions, constitutional indifference, racism, sexism, minority hatred, divisiveness, etc.

But, Frances adds, “none of these horrid personality features constitutes anything approaching a mental disorder. And mislabeling them [a] mental disorder has two seriously harmful unintended consequences” — stigmatizing people with mental illnesses and trivializing those illnesses.

FMI: Frances’ essay can be read online in the Huffington Post. You’ll find Kennedy’s op-ed on the Washington Post website and Molchan’s article at HealthNewsReview.

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Comments (8)

Whatever...

No kidding! Nothing like hearing various cable heads speculate on anyone's wiring. Media people who put these diagnoses in print really do need to "couch" their words.

Besides: If anyone could truly analyze this guy, only a Freudian would succeed, and there ain't none of them left.

How to get Trump out of your life

Trump was born at home plate and feels like he hits a homerun all the time, which makes him grossly out of touch with those having to deal with the pressures of not living at home plate.

I suspect Trump’s dad had one of two motivations when he gave The Donald the million dollars or whatever the right number is. He either wanted The Donald out of the house and away from him or he thought he was doing the right thing for his son. It is never good to give anyone, without a value system, large sums of money. Donald is the proof of that.

Donald speaks daily and there isn’t a person alive that can tell you what he honestly stands for. I don’t believe anyone can say what he is truthfully against, either, as over time he has been on both sides of everything he has ever said. He will talk both sides of the fence in the same sentence.

I think the best way for me to get The Donald out of my life is to not vote for him and he will go back where he came from. I feel sorry for his seemingly fairly-balanced offspring having to defend a person who cannot be rationally defended. Even his talking heads are having to make up ridiculous things to justify what he has said. Now they look nothing but foolish, just as Trump does.

Fair and balanced....

As an armchair psychologist, I think H. Clinton sufferers from mythomania & pseudologia fantastica.

I think this deserves more discussion.

"Singularly Undistressed"

"Personality Disorder requires that the individual’s personality characteristics causes clinically significant distress or impairment. Trump’s behavior causes a great deal of significant distress and impairment in others, but he seems singularly undistressed and his obnoxiousness has been richly rewarded, not a source of impairment."

That raises an interesting point. Perhaps Trump is so wealthy that he is able to insulate himself from the normal consequences of his behavior. An ordinary working person who behaved like Trump would most likely have been kicked to the curb by any intelligent employer long ago. He also would have been a social pariah. The very rich don't suffer those consequences, so they can remain "undistressed."

Yes, but

I think concerns about "stigmatizing" the mentally ill in this context are overblown. Discussions using psychiatric language amount only to a few waves in the raging ocean of media coverage of this campaign.

The list of Trump's characteristics cited by Dr. Frances have been discussed much more often in terms of "temperament." ( "...habitual dishonesty, bullying, bravado, bloviating ignorance, blustery braggadocio, angry vengefulness, petty pique, impulsive unpredictability, tyrannical temper, fiscal irresponsibility, imperial ambitions, constitutional indifference, racism, sexism, minority hatred, divisiveness..."

These behavioral patterns are precisely why Trump finds himself in an almost insurmountable deficit against Clinton. I think he finds this plenty stressful or else he wouldn't be throwing out wild accusations that the election will be "fixed."

Does he have an actual personality disorder? I don't know, and at this point it is not important. But, as Trump would say, something is going on.

Are people who advocate violence sociopaths?

Donald Trump has advocated violence, assassination of public officials and the murder of wives and children of alleged terrorists in reprisal. Ask a jury of 12 mental health professionals whether or not that indicates a sociopathic personality. If not, then tell us who does. Do people have to actually hurt or kill someone to qualify?

Trump

Is the fact that it might be demeaning to others a sufficiently compelling reason not to think about Trump in these terms?

Another perspective

Dr. Frances criticizes armchair psychiatry. He says that professionals should not be diagnosing Trump as mentally ill based on second hand observation. I would point out that suggesting Trump is not mentally ill is no different. Without careful examination as a patient, it is not possible to judge Trump's mental health. In healthcare, new diseases and disorders are found as our knowledge of the human experience deepens. Trump could be the first diagnosed victim of a new disorder.

Trump needs a psychiatric assessment. When he was in second grade, he claims he gave a teacher a black eye because he thought she didn't know as much about music as him. At that point, he needed a psychiatric evaluation, but appearing did not get one. He had reported how he preys on women, which a dozen women recently collaborated. That again suggests there is something wrong with him. It may be that he has multiple mental health issues that somehow don't get attention if a person is protected by their wealth and power.

We all want to know what he acts in the bizarre and mean spirited way he does. That an easy explanation isn't available doesn't mean we should try to figure it out, given the damage his is doing to our nation and world.