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President Donald Trump

Trump Isn't Crazy

I wrote the DSM criteria and he doesn't meet them.

Trump's mental health is a trending topic on the Internet, on the air, and in newspapers. A petition requesting he be required to submit to a psychiatric evaluation has already received 8000 signatures. This is well meaning, but inaccurate and misguided.

Trump's consensus diagnosis among amateur, at-a-distance diagnosticians is Narcissistic Personality Disorder. They have reviewed the DSM definition (which I wrote) and found him to meet all the criteria: grandiose self-importance; preoccupations with being brilliant and successful; feeling special and having to hang out with special people; requiring constant admiration; feeling entitled; being exploitive; lacking empathy; being envious; and being arrogant. Bingo. Trump is all this in spades.

But they ignore the further requirement that is crucial in defining all mental disorders—the behaviors also must cause clinically significant distress or impairment.

Trump is clearly a man singularly without distress and his behaviors consistently reap him fame, fortune, women, and now political power. He has been generously rewarded, not at all impaired by it.

Dismissing Trump as simply mad paradoxically reduces our ability to deal with his actions.

Trump isn't crazy.

The American Psychiatric Association has a useful ethics policy that explicitly prohibits the diagnosis of politicians at a distance. In the 1964 presidential election, liberal psychiatrists had taken cheap shot against the radically conservative Republican candidate, Barry Goldwater—publicizing their “diagnosis” that he was too mentally ill to be a safe custodian of the nuclear button. They had no right to use a professional credential to slur Goldwater in this way, medicalizing what was essentially no more than a political disagreement.

The psychiatrists and psychologists who are now publicly diagnosing Trump feel compelled by the higher call of national interest to break any restrictions against diagnosis at a distance. But the argument fails because their diagnosis is poorly informed and simply wrong.

Please stop calling Trump mentally ill and please stop talking about psychiatric evaluations or impeachment. This embarrasses us more than it does Trump. And the people around Trump are even more dangerous than he in the long run.

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