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 Dec 25, 2016

Crisis: Is Donald Trump Mentally Ill?
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Introduction

1. Is Donald Trump Mentally Ill?

Introduction:

This is a Nederlog of Sunday, December 25, 2016.

A.
This is a crisis log that differs from normal crisis logs (of which I wrote now since September 2008 over 1400 files) in being written on Christmas day and in being only about the characteristics of Donald Trump, who has been elected as president of the USA starting January 20, 2017.

The present file consists of just one item: A letter that was sent by - it seems - three professors of psychiatry to president Obama on November 29, 2016.

I recommend that you read the letter, which strongly supports my own - psychological - estimate of Donald Trump, that follows.  And it is reproduced here because I am not sure it will be available when Trump is president.

Incidentally, I added 7 notes, that are all identified by "[Mx]" where x is a number between 1 and 7. (All are short and most are not very important.)

1. Is Donald Trump Mentally Ill? 3 Professors Of Psychiatry Ask President Obama To Conduct 'A Full Medical And Neuropsychiatric Evaluation'

Richard Greene Communication Strategist, Author of "Words That Shook The World"

I received this stunning letter to President Obama from a source, with written permission from Dr. Herman, Dr. Gartrell and Dr. Mosbacher, because the source knew that I had been interviewing Psychiatrists and Psychologists about Donald Trump's alleged "Narcissistic Personality Disorder".

Virtually every mental health professional I interviewed told me that they believed, with 100% certainty, that Mr. Trump satisfied the DSM criteria of this incurable illness and that, as a result, he is a serious danger to the country and the world. [M1]

Listed below is a summary of their comments and an overview of this psychiatric condition. To provide further context, here is a short and a longer interview [M2]

with Dr. Lynne Meyer, a Psychologist specializing in personality disorders, brilliantly explaining how such a disorder might help us understand Mr. Trump's comments and behaviors and the challenges that likely lie ahead for our country.

President Barack Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

November 29, 2016

Dear President Obama,

We are writing to express our grave concern regarding the mental stability of our President-Elect. Professional standards do not permit us to venture a diagnosis for a public figure whom we have not evaluated personally. [M3] Nevertheless, his widely reported symptoms of mental instability -- including grandiosity, impulsivity, hypersensitivity to slights or criticism, and an apparent inability to distinguish between fantasy and reality -- lead us to question his fitness for the immense responsibilities of the office. We strongly recommend that, in preparation for assuming these responsibilities, he receive a full medical and neuropsychiatric evaluation by an impartial team of investigators. [M4]

Sincerely,

Judith Herman, M.D.
Professor of Psychiatry
Harvard Medical School

Nanette Gartrell, M.D.
Associate Clinical Professor of Psychiatry
University of California, San Francisco (1988-2011)
Assistant Professor of Psychiatry, Harvard Medical School (1983-87)

Dee Mosbacher, M.D., Ph.D.
Assistant Clinical Professor
Department of Community Health Systems
University of California, San Francisco (2005-2013)

The Diagnostic and Statistical Manual (DSM - 5, Cluster B) for "Narcissistic Personality Disorder" by The American Psychiatric Association (APA)

Here, according to The APA, are the 9 criteria for "Narcissistic Personality Disorder". If an individual has 5 out of the 9 they have a confirmed diagnosis of this illness. Many individuals have "traits" of narcissism but only about 1% of the population has clinical NPD.

"Summary : A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following [M5]:

1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believe that he or she is "special" and unique and can only be understood by, or should associate with other special or high-status people (or institutions)
4. Requires excessive admiration
5. Has a sense of entitlement
6. Is interpersonally exploitative
7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
8. Is often envious of others or believes that others are envious of him or her.
9. Shows arrogant, haughty behaviors or attitudes."
[M6]

What does it mean if someone does have NPD?

If someone does have "Narcissistic Personality Disorder" they can, indeed, wake up, see a Tweet or a news report from a foreign leader criticizing him, mocking him, calling him "weak" or threatening his ego in any way and order some kind of impulsive, vindictive, punishing, immediate response that could include an unhinged order to attack that foreign leader or foreign country with military force, even including the authorization of nuclear weapons.

It is extremely likely that there would be some kind of impulsive, angry diplomatic response.

Because someone afflicted with this incurable and progressive "Narcissistic Personality Disorder" simply can't help himself.

Here's why:

1. People with NPD are extremely sensitive and insecure. They psychologically require constant compliments and acknowledgement because they do not have their own internal self-esteem. They need to get it from others.

2. If someone does criticize them, even in a Tweet or on a television comedy show, it triggers this deep and painful lack of self-esteem and they MUST lash out to relieve the pain of the criticism.

3. They have only two modes: They are either fully your friend and love you or you are their enemy and they will do everything to discredit you or humiliate you. They can't help it. The pain of having someone in their circle who does not approve of them or acknowledge them, (almost constantly), is too great.  

4. There are only two ways to deal with someone with NPD, and they are both dangerous. There is no healthy way of interacting with someone with this
affliction. If you criticize them they will lash out at you and if they have a great deal of power, that can be consequential. If you compliment them it only acts to increase the delusional and grandiose reality the sufferer has created, causing him to be even more reliant on constant and endless compliments and unwavering support.

5. Because they crave the attention and approval of others they develop great capacity to engage and entertain and can be quite charismatic, even to the point of developing a cult-like following.

6. Someone with NPD will NEVER get along with any member of the press, or any media outlet that criticizes him. 

7. Someone with NPD will NEVER hire (and will fire) anyone who criticizes him. Therefore, and because they believe they know better than almost everyone else, they have a very hard time listening and taking any advice.

Concerns Expressed by Mental Health Professionals

The President of The United State and Commander in Chief is the only American who has ANY say over the mobilization of The United States Military, the authorization of a military strike on a perceived or real enemy and the launch of any and all of the weapons possessed by The United States Military, including 7,000 nuclear warheads.

There is no "Fail Safe". There is no "Team". There is no thoughtful review.

The National Security Advisor, The Secretary of Defense, The Secretary of State, The Joint Chiefs of State and every General in the military can all emphatically say "NO!" but if The Commander in Chief wants to initiate military and even nuclear action, NO ONE can stop him. American law does not allow a military officer to make those decisions.

Only a civilian, The President, elected by The American People can access the nuclear codes. Only that President can use the nuclear codes.

And if he does, the military is duty bound to follow his order.

A President and Commander in Chief who does have Narcissistic Personality Disorder would be very dangerous to all Americans, and the world. [M7]

Note: A Clinical Psychologist wrote the author to confirm (and expand upon) the dire analysis of Dr. Lynne Meyer and the concerns of the 3 Professors in this article. It is worth including here, especially her very unique perspectives on the role of Trump's daughter Ivanka.

"Dr. Meyer is spot on in her assessment in the video. It is particularly good to hear her make the distinction between mental illness and personality disorders with their pervasive, inflexible, permanently fixed and incurable patterns of pathological behavior. This is one aspect of Trump's problem that's routinely misunderstood, even by some experts.

She also makes an excellent observation, among many, about Trump's grandiosity being behind his refusal to have daily intelligence briefings. 

Another, and related reason is the fact that he is cognitively so limited that such briefings make no sense to him (and that's why he wants Ivanka, for example, or Jared with him during similar occasions, to help him understand what's being said). Additionally, and also relatedly, his profoundly deficient attention makes it impossible for him to focus on any stimuli that do not provide him with adulation. He's quickly bored by and dismissive of anything that does not have to do with himself.

The point about him getting worse in the future also cannot be overstated. An increasing paranoia combined with growing sadistic vindictiveness is pretty much a given. We have seen it consistently in other leaders, past and present, with this character defect. 

And being so impulsive and without a conscience, he won't stop for a moment before putting his primitive impulses into action. Those who believe that they can somehow "control" him, or that our democratic "checks and balances" can withstand the collusion between his personal pathology and that of his willing sycophants, are deluded, I'm afraid. 

The man is unfit to run a lemonade stand, much less a country. That so many have decided to ignore his profound character defect, or turn it into an asset in their eyes, is horrific, but, sadly, not surprising".

--------------------------
Notes

[M1]
I note that this holds for "virtually every mental health professional" that was interviewed, and also accords with Dr. Lynne Meyer's testimony in the video that follows below (with a dot).

[M2] As it happens, the first of these interviews does not reproduce. So there is only the second, with Dr. Lynne Meyer.

[M3]
Actually, I doubt this holds for "a public figure" and for two reasons:

First, public figures are less private than non-public figures (which is accepted by the American courts), and second, many public figures refuse to meet a psychiatrist or psychologist if these are out to diagnose them.

Then again, I think this whole (mostly artificial) difficulty can be avoided if we avoid the term "diagnosis" and instead speak of "an estimate in the light of  professional knowledge".

For that is what it says it is, and it avoids the term "diagnosis".

[M4]
I completely agree - but add that I do not think this will happen, for reasons explained further below.

[M5] Incidentally, I disagree with the DSMs and indeed also with this "5 out of 9" criterion (because there are no less than 120 ways in which one can take 5 things out of 9 things - which in the case of a psychiatric judgements makes it quite vague).

Then again, as I myself also verified: Donald Trump scores 9 out of 9.

[M6]
As I said, in my - psychologically trained - eyes, Trump scores 9 out of 9.

[M7] I quite agree, and if you disagree, you should reread this part, and start with "
Concerns Expressed by Mental Health Professionals".

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