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