Today the Daily Beast that asks: How Close Is Donald Trump to a Psychiatric Breakdown? Crucially the authors ask “ will the president approach a psychiatric breakdown before, or after, he fires Mueller?”
I suggest you read the entire article, although if you’re familiar with the Goldwater Rule controversy, and the history of the mental health duty to warn movement, you may want to skim through those sections to get to the clinical meat of the article which is reflected in the title.
The article is written by Rosemary Sword who is co-developer of Time Perspective therapy with the well-known psychologist Philip Zimbardo, the Stanford professor emeritus and author of Stanford prison experiment most psychology majors studied in college, and Gail Sheehy. She is a journalist and the highly regarded author of 17 books, including Passages and Character: America’s Search for Leadership.
I have written about the psychological defense mechanisms employed by malignant narcissists like Trump to protect their fragile egos. When a malignant narcissist feels attacked (technically suffers a “narcissistic insult”) he tends to react with narcissistic rage. I wrote about this way back in August 2016. We see this all the time with Trump.
But the question dozens of shrinks who I communicate with every day through a private Facebook page have been asking is what it will happen if his defenses no longer function. The answer we have come up with is that he is likely to have some kind of severe mental breakdown, possibly a psychotic episode. In fact, my friend, contributor to “The Dangerous Case of Donald Trump” and the founder of our Facebook page is quoted in The Daily Beast article:
Howard Covitz, a Philadelphia psychoanalyst and former director of the Institute for Psychoanalysis and Psychotherapy, pointed out that the Goldwater Rule, as it now stands, has no limits. “Hypothetically, a president could be hallucinating and running on the White House lawn buck naked, screaming ‘Bring me my nuclear codes!’ and the new rule would continue to gag professionals from speaking up.”
Politically this would be difficult, if not impossible, to ignore because his symptoms would be so obvious.
The authors of the Beast article suggest that Trump is showing signs of mania.
To verify the symptoms of mania, Sheehy sought out Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University’s medical school and a former president of the American Psychiatric Association who has produced 10 books on mental illness and psychiatry. This conversation took place in the summer of 2016.
“Manic personalities are imbued with a sense of self-importance, grandiosity, and mission,” Dr. Lieberman said, taking care to add that this is true of most people who seek the presidency. Granted, anyone with the audacity to assume that he or she has what it takes to lead the world’s superpower will exhibit an excess of narcissism and its offspring—a sense of entitlement—along with a grandiosity of ambition and some degree of messianic belief that she or he is the ideal rescuer-protector for the times. But early on, Donald Trump crashed through the sound barrier on all such temperamental traits.
Dr. Lieberman elaborated on the fragmented thinking process of a person suffering from mania. They jump from subject to subject, not following a line of logical reasoning, no thematic consistency. They need less sleep, or don’t sleep at all.
The average person doesn’t need a Ph.D. to peg Trump in ordinary words as “a raging, overbearing, egotistical, obnoxious boor,” as professor Lieberman observed. But what goes on in the brain of a manic temperament is more dangerous than just obnoxious. “There is a biochemical disturbance in a part of their brain that involves regulating moods,” Lieberman said. “Instead of being able to re-stabilize a highly emotional state, they remain in a period of excess. That state can persist for days, weeks, or even months.”
This sounds like a dead ringer description of the state of Trump’s mind in recent months as he sleeps less and tweets more—up to as many as a dozen times a day—to create a perpetual disarray in government and a constant distraction from what he most fears.
They do not use this term colloquially. It is a clinical term, a syndrome. Let’s once again go to Wikipedia:
Mania is a state of abnormally elevated arousal, affect, and energy level, or “a state of heightened overall activation with enhanced affective expression together with lability of affect.” Although mania is often conceived as a “mirror image” to depression, the heightened mood can be either euphoric or irritable; indeed, as the mania intensifies, irritability can be more pronounced and result in violence, or anxiety.
The symptoms of mania include heightened mood (either euphoric or irritable); flight of ideas and pressure of speech; and increased energy, decreased need for sleep, and hyperactivity. They are most plainly evident in fully developed hypomanic states; in full-blown mania, however, they undergo progressively severe exacerbations and become more and more obscured by other signs and symptoms, such as delusions and fragmentation of behavior.
Mania is a syndrome with multiple causes. Although the vast majority of cases occur in the context of bipolar disorder, it is a key component of other psychiatric disorders (such as schizoaffective disorder, bipolar type) and may also occur secondary to various general medical conditions, such as multiple sclerosis; certain medications may perpetuate a manic state, for example prednisone; or substances of abuse, such as cocaine or anabolic steroids. In the current DSM-5, hypomanic episodes are separated from the more severe full manic episodes, which, in turn, are characterized as either mild, moderate, or severe, with specifiers in regard to certain symptomatic features (e.g. catatonia, psychosis). Mania is divided into three stages: hypomania, or stage I; acute mania, or stage II; and delirious mania (delirium), or stage III. This “staging” of a manic episode is very useful from a descriptive and differential diagnostic point of view.
Trump decided that the best place to spend the weekend was at his summer palace, thus avoiding the March For Our Lives. However, the assaults on his psychological defenses are escalating on several fronts, most notably the Mueller investigation getting closer and closer to implicating him, and his “woman” problem is culminating in what will probably be one of the most viewed 60 Minutes of all time.
We don’t know what, if anything, will be the final trigger for a mental breakdown. It could happen behind closed doors when Melania finally tells him she’s had it with the charade of playing the loyal First Lady.
Whatever will set him off, let’s hope there’s someone there to stop him from starting a war as the ultimate expression of narcissistic rage.
Melania was a model and could easily put on a happy face if she wanted to do so. She doesn’t look particularly happy here considering she is about to stay at Mar a Lago for a so-called vacation.
How much emotional comfort can the besieged Trump expect from her this weekend? Is she going to be watching the March For Our Life coverage? Is she going to watch 60 Minutes?
How detached from reality is Trump today? This could be an indication. Or perhaps it shows his rage, giving the finger to the million marchers in DC.
Our thoughts and prayers are with the victims of the horrible attack in France yesterday, and we grieve the nation’s loss. We also condemn the violent actions of the attacker and anyone who would provide him support. We are with you @EmmanuelMacron!
— Donald J. Trump (@realDonaldTrump) March 24, 2018
It’s his only Tweet of the day, although we don’t know if it is from him or Daniel Scavino Jr. the White House Director of Social Media who often write his Tweets.