Wednesday, April 26, 2017

[Unintelligible.]: Trump’s mental health
and the questions that won’t go away

THE WORLD according to Trump is a frighteningly disjointed, bizarro-Tetris-on-steroids, Machiavellian, zero-sum-game mashup of situational identities, convenient allegiances and, always and always, vast financial entitlement. And for all who would have us believe that the Trump world view is animated by intent — that all of this crap, every aspect of his public persona, is on purpose — there’s a growing number of clinicians, mental health experts and health professionals who are coming to a more sobering assessment: Donald Trump can’t help himself, his mental health is bad and it’s getting worse.

Bob Cesca in Salon picked up on some of the behavioral anomalies: “When he desperately avoids details by rotating through his mental rotisserie of superlatives (‘very, very’ or ‘tremendous’ or ‘terrific’ or whatever hyperbolic pitchman gibberish he’s trained himself to repeat), he comes off as an uninformed dolt, conspicuously avoiding questions with more vigor than he avoids strong gusts of wind.

“Conversely, when Trump struggles to repeat issue-oriented details, he comes off as a scattered, barely coherent toddler attempting to repeat something he heard at the grown-ups’ table and failing badly.”

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That’s part of the problem. Some of the rest is found in a partial transcript of a Trump interview with The Associated Press, the president-apparent responding to AP about the importance of the presidency and the responsibilities of the job:

“Number One, there’s great responsibility. When it came time to, as an example, send out the 59 missiles, the Tomahawks in Syria. I’m saying to myself, “You know, this is more than just like, 79 missiles. This is death that’s involved, because people could have been killed. This is risk that’s involved, because if the missile goes off and goes in a city or goes in a civilian area — you know, the boats were hundreds of miles away — and if this missile goes off and lands in the middle of a town or a hamlet . . . every decision is much harder than you’d normally make. [Unintelligible.]

“This is involving death and life and so many things. . . . So it’s far more responsibility. [unintelligible].”

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THE PALMER Report, a news blog by Bill Palmer (founder, editor in chief, and muckraker in the best sense of the word), put things in perspective just after Easter weekend: “Over the weekend Donald Trump humiliated himself by not remembering to put his hand over his heart during the Easter Egg Roll, and then taking a kid’s hat from him and autographing it before randomly flinging it into the crowd – seemingly forgetting that the kid had just handed it to him.

“Then he went on Fox News and unwittingly revealed he didn’t remember that Kim Jong-Il gave way to Kim Jong-Un in North Korea six years ago.

“Then he began repeatedly referring to his close ally Paul Ryan as ‘Ron’ during a Tuesday rally in Ryan’s home state. And this came after Trump bombed Syria and then immediately announced that he had bombed Iraq instead.”

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Recently, The Palmer Report retweeted the observation of Brenda J. Iannucci, M.D., a medical doctor and cognitive function specialist in New York state. Dr. Iannucci (tweeting as Brenda Ji) summed up Trump’s apparently deepening lack of recall in the following fashion: “Cognitive failure in Trump: naming functions located frontotemporal regions of brain. Recall and reasoning fail concurrently.”

It’s not the first time health problems have been expressed as the reason for Trump’s rather ... singular behavior, which started before his installation on Jan. 20th.

It’s thought by some that Trump suffers from malignant narcissism, characterized by a thirst for admiration; a more or less universal suspicion of anyone outside an inner circle; aggression ... and a host of other malign behavioral patterns.

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USING from-afar clinical assessments of Dr. John D. Gartner, a psychologist formerly on the faculty at Johns Hopkins, and conclusions distilled from anecdotal examples and the comments of Trump intimates (including ex-wife Ivana Trump), journalist Shane Show came to the “diagnosis” that Trump is plagued with malignant narcissism. Snow’s conclusions, though not coming from a clinician in the field, are nonetheless a compelling read (complete with play-by-play and a scorecard), whether you think he’s right or not.

Snow’s analysis gets additional traction from Gartner, whom Snow interviewed for his blogpost. Gartner described for the journalist the origins of the phrase “malignant narcissism”:

“The concept was developed by a famed psychologist named Erich Fromm, who escaped Nazi Germany, as a way to describe evil,” Gartner says. “He used it to describe Hitler.”

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In February, The New Republic boldly speculated that our asterisked chief executive “may have an untreated sexually transmitted disease that has led to a condition called ‘neurosyphilis,’ characterized by ‘irritability, loss of ability to concentrate, delusional thinking, and grandiosity.’”

Psychoanalysts and psychiatrists are also considering Trump’s behavior as the manifestation of a “dark triad” personality exhibiting three specific traits: machiavellianism (an inclination toward manipulative behavior), narcissism (excessive love of one’s self), and psychopathy (a lack of empathy).

More than 52,600 health professionals have signed a petition seeking Trump's removal from office "according to article 3 of the 25th amendment to the Constitution." That’s up from 25,000 who’d signed as of mid-February.

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AND THEN there’s the 35 mental-health professionals and social workers who signed and published a letter in The New York Times on Feb. 21, claiming that Trump showed a “grave emotional instability” making him “incapable of serving safely as president.”

And there’s the New York magazine report from April 23rd. Gail Sheehy reported on a recent Yale Medical School town meeting attended by various professionals in the field — men and women unbound, speaking their minds as citizens as much as anything else.

At the town meeting, Sheehy reports, “Dr. James F. Gilligan, a senior clinical professor of psychiatry at NYU Medical School, said that, while speculative diagnoses of Trump have been made, one does not need a diagnosis to assess dangerousness. Anyone who doesn’t flatter him extravagantly is meant to be destroyed. He engages in exploitation and violation of the rights of others, and sometimes goes as far as sadism, with no evidence of remorse.

“ ‘When you add all these elements, this is a class of people of whom Hitler is a member,’ ” Gilligan observed, apparently unaware of Gartner’s same invocation of the name of evil.

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These and other frank interpretations of Trump’s mental health are taking place in direct violation of the 44-year-old Goldwater rule, a tenet of the code of ethics of the American Psychiatric Association that bars mental-health clinicians from making diagnoses of public figures without access to the patient. For these professionally conscientious mental-health pros, the current situation is that serious.

Whatever Trump’s problems are, or may be, they shouldn’t confront the American public or be inflicted on the American people. We shouldn’t be held hostage or made human guinea pigs in the furtherance of political agenda. Because whatever those mental problems are, the road for House Trump isn’t going to get any smoother from here on in. With big challenges ahead, foreign and domestic, the country needs a clear-eyed, clear-headed leader whose ability to confront those challenges is equal to his willingness to do so.

The world according to Trump is an angry, disputatious, problematic place for the citizens of this nation and elsewhere. It’s time for a brutally clinical assessment of whether or not the current occupant of the White House is capable of dealing with the world according to the world.

Image credits: Trump: via The Hill. AP logo: © 2017 The Associated Press. Malignant narcissism scorecard: Shane Snow's blog. The New Republic logo: © 2017 The New Republic. APA logo: © 2017 American Psychiatric Association.

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