Vox / YouTube The awkward debate around Trump ...
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Bandy Lee, Md, MDiv, the forensic psychiatrist who edited and contributed to “The Dangerous Case of Donald Trump” and Tony Schwartz who spent hours with Donald Trump when he wrote “The Art of the Deal” for him wrote an important article published in Politico Magazine in Politico’s ongoing Trumpology series.

Inside the Mind of Donald Trump: He’s grandiose, deceitful and paranoid—but don’t let him drive you crazy.

There is a division among mental health professionals about whether it is valid or wise to diagnose Trump. This has been a debate it has been a distraction for many people. The characteristics observed in Trump’s behavior as laid out in the Lee and Schwartz article may or may not be grist for the diagnostic mill among mental health professionals.

Justifying how psychiatric labels apply to Trump in the media has not been as productive as some of us hoped it would be. I am as guilty as anyone who tried to use a diagnosis to warn about how dangerous Trump was, and effort which at some times backfired.

It would hardly matter if a panel of the best diagnosticians in the country spent hours interviewing the president and subjecting him to a battery of psychological tests since many psychiatric diagnoses are highly subjective.  As has been noted by many clinicians, someone like Trump could present a false self in order to hide psychopathology.

There’s no compelling need for a psychiatric diagnosis because the characteristics and behaviors summed up in this article taken together should prove that Donald Trump is an existential threat to democracy and to world safety.

From the article: It isn’t possible to reliably diagnose any individual from a distance, but it is reasonable to flag clear, observable signs of impairment and to make inferences based on repetitive patterns of behavior. There is a significant difference between diagnosing a specific disorder and analyzing the meaning of the qualities Trump exhibits, such as paranoia, grandiosity, lack of empathy and pathological deceit. Trump’s behavior, we believe, is the predictable outgrowth of this psychological disposition, exacerbated by the stress of the intensifying criminal investigations he faces.

No diagnosis is proffered in this article and none is necessary.

These are the words and phrases used in the article to describe Trump behaviors. They are based, not on a face-to-face clinical assessment, but rather on the observations we all have been making.

These are the words and phrases used to describe Trump:

  • irrational, impulsive, self-destructive
  • paranoia
  • grandiosity
  • lack of empathy
  • pathological deceit
  • increasing grandiosity
  • growing paranoia
  • (using ) bizarrely admiring words
  • redefine(s) reality
  • volatility
  • severely limited attention span,
  • unable to regulate his emotions,
  • he reacts angrily, and often with threats of revenge, to any challenge to his authority
  • overwhelms his capacity to focus on nearly anything else.
  • Trump’s grip on reality will likely continue to diminish
  • He lies without guilt.

Men with parents like Trump had can:

  • become hypersensitive to slights
  • their envy can prompt them to take sadistic pleasure in tormenting perceived enemies

It matters less whether these characteristics are labeled as symptoms of one or more psychiatric diagnoses than that when added together they paint a picture of someone who is unfit to hold any responsible job involving the safety of others, let alone to be president of the United States.

Before concluding the article with helpful advice (summarized below *) as to how we all can maintain our own mental health, the authors sum up their conclusions and show us why we should be alarmed about what they believe is going to happen with Trump in the future:

Trump’s grip on reality will likely continue to diminish as he faces increasing criticism, accusations, threats of impeachment and potential criminal indictments. We can expect him to become more desperate, more extreme in his comments, more violent in his threats, and more reckless and destructive in his actions. His latest extreme threat to Iran is one example, and he is likely to return to similar threats to North Korea if he feels that Kim Jong Un is making him look weak and unsuccessful.

* Helpful advice for surviving Trump

  • “Trump thrives on creating fear and sowing confusion. He lies without guilt. Don’t match his emotion with your own.”
  • “…be clearer than ever about your core values, beliefs and principles, and rely on them for guidance and comfort, especially when you are feeling most triggered and fearful. Challenge every day the natural inclination to feel overwhelmed, fatigued or numb in the face of Trump’s behavior.”
  • “..recognize that fear is your enemy. Holding onto the opposites of realism and optimism is the best antidote.”
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This is a Creative Commons article. The original version of this article appeared here.


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