Well, I happen to think capitulation to a foreign power, just because you don't want an investigation that makes you look bad, is dangerous.

YMMV, and I have no idea why.

This is going to be a long post, addressing several items that have come up in this thread. It's an attempt to bring a pile of fractured arguments back together into a bigger picture that isn't one-dimensional or black-and-white.

1) Is Trump Normal?

No, he isn't. But neither am I, and neither are the majority of people on this whole board. There are many ways in which he's not normal:

• He's the president, which is not normal all by itself
• He was wealthy and powerful even before becoming president, which hardly represents normality compared to the average person
• He is more arrogant and self-centered than most people, although I've met a handful of people whom I consider to be nearly as arrogant and self-centered, they just haven't had the benefit of wealth and power to go with it
• He appears more petty and retaliatory than most people, but again I know other people who are as petty and retaliatory but who don't have the wealth and power to do much more than be a pain in the backside
• His hair is stupid and he needs a better quality spray tan (this may be the most abnormal thing about him)

2) Is he dangerous?

No, I don't really think he is. I know, I know, he has the ability to cause negative consequences. That's not actually what a claim of dangerous to oneself and others means in the context of mental health. And yes, I know... OMG the button! As much as there's been fear-mongering on this point, I don't think that's a plausible concern for a variety of reasons. But if it pleases you to lose sleep over it, I won't stop you. Here are reasons why I don't think he's particularly dangerous:

• He doesn't have a history of violence or physical aggression - offhanded comments about grabbing women's genitals aside, he hasn't, to my knowledge, been involved in any physical altercations, physical threats, or similar
• He's known to be a bombastic loudmouth who fires off empty threats on a regular basis that he doesn't follow through on
• Every other president has had the same potential for the same sort of danger that Trump has, so it's a matter of circumstance more than anything else

3) Does Trump have a mental health disorder?

Maybe. I'm not a psychiatrist, and neither is anyone else in this thread. Not a one of us is qualified to determine whether he actually has a disorder, or if he's just a serious ******* who has a constant spotlight highlighting every stupid, arrogant, or thoughtless thing he does. In my opinion, he certainly could be described as a narcissist in the colloquial sense, and a blowhard jerkwad in any sense. But I don't know that he meets a clinical definition of Narcissistic Personality Disorder - I'm not qualified to judge (and neither is anyone in this thread, all I can do is read the checklist online, but I know that's not sufficient all by itself. And I have some skepticism regarding the small handful of professionals who have made a public diagnosis.

I do think it's clear that his cognitive function is declining. Again, I'm not a doctor, but a simple comparison of his speaking ability from 5 years ago to present seems to suggest that his ability to think clearly has declined. I can't really opine about the cause of that - it could simply be age, it could be stress, hell it could be a side effect of a drug taken for some health condition, it could be drug abuse or alcoholism, or any number of things. I can observe the symptoms, and that's about it.

He is, however, really bad at making decisions, in my opinion. So are a lot of other people, but he's in a position where the effect of those bad decisions is magnified. It's not a mental disorder by any means, but it is something to take into consideration.

4) Is Trump a good president?

No.

He is really bad at making decisions, in my opinion. So are a lot of other people, but he's in a position where the effect of those bad decisions is magnified. That's something to take into consideration.

5) Is Trump the worst president ever?

I don't know, and won't know until well after the fact. He's probably in the top three. That's a question for history to answer

6) Should the 22 or so Mental Health Practitioners who have made public diagnoses be believed simply because they are professionals and their views coincide with mine?

No, I don't think they should. First off, it's a very small portion of Mental Health practitioners who have spoken out; it's a smaller portion of that field than we have for scientists disagreeing with APG. They might be right, sure, but at present the only reason to accept their conclusion is because it confirms our own biases. Given that Trump is sooooo strongly detested and hated by a large number of people, diagnoses of this sort should be suspect. In general, any situation that involves a negative conclusion as well as extremely strong emotions should be considered somewhat suspect.

Additionally, even if they are correct in this case, they're not following the appropriate standards for forming that diagnosis. Both the American Psychiatric Association and the American Psychological Association have expressed the view that public diagnoses of political figures are inappropriate. The only organization that hasn't is the Psychoanalytic association (I forgot what it's called)... but they don't make diagnoses.

And even larger than the practice standards involved, is the ethical precedent created. I'm in full support of the views of these professionals being used to require a president to go through a psychological evaluation by a competent and objective professional. I think that makes good sense. I am completely opposed, however, to using the opinion of a very few people leaning on their authority as a wedge with which to remove a president in an extremely heated and partisan environment. Once it's been done with this president... the same can be done for any president in the future.

And no matter how much you or I might disagree with classifying Obama or Bush, or any prior president as having had a serious disorder... I'm fairly certain that there are at least 22 Mental Health practitioners out there who could use public appearances and behavior to make a case for narcissism, anti-social disorder, or any other number of mental disorders as it fit their own biases.

And I personally think that's a much larger threat to American democracy than anything Trump can do.

The standard I've come up with is based on people I've met and have and personal interactions with. Since I've never met Trump, and never had any interactions with him, I can't speak to his mental state.

I've got no idea if he is normal since I don't know the man. I do not feel comfortable accepting medical diagnoses based on what people view through the filter of the media. Which is, in most cases, biased based on which source you chose to watch.

There is so much out there on Trump besides what one sees on the media. It would be a mistake to think people assessing Trump as having a personality disorder were only going by a few newsreels and The Apprentice.

You can't possibly know that.

If I were happy about it, I wouldn't be calling it a **** show.

What went down yesterday? Trump calling out the US intelligence community, instead of calling out Vladimir Putin? Yeah, that bothered me. I think probably not to the extreme degree that it bothered you, though, and probably not for all the same reasons.

But the crux of this sidebar is that you have a habit of trying to force me into a stereotype that fits the arguments you want to have, instead of taking the time to listen to and understand what I actually think.

You need me to believe certain things, in order to justify you calling me deplorable. You're not really interested in finding out whether I'm really as deplorable as you imagine. And that attitude, that need, colors all of your interactions with me. And it appears to be more or less incorrigible. At some point, you stop being able to offer me anything worthwhile, in exchange for my efforts to explain myself to you. In fact, generally speaking, I'm past that point already on this forum. I'm making an exception for you right now because I still see some possibility that it might be different this time. But that possibility is fading fast.

And beyond that, it colors everything. Because I’m not just falling in line, accepting these shrink’s opinions, well, I must be a Trumpkin. That’s not the case at all. But it makes it easier to dismiss my arguments, I guess.


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Your posts in other threads lean right. But for the record, I don't think support of Trump is your main problem here. I think it's that you are digging your heels in lest you have to admit you read something on the internet and you really aren't knowledgeable about the subject.

I know that nobody in this thread has presented appropriate qualifications for making such an assessment.

Ditto.

There are two themes in this thread. One has to do with professional medical types diagnosing politicians. I could care less about that.

The other, which is far more interesting IMO, is whether Trump has NPD. I think this is obvious beyond all shadow of a doubt and I just have to shake my head in amazement at people who A) don't acknowledge his NPD, and B) can't even claim Trump's not normal.

It doesn't mean whoever can't see it is a Trumpkin, but I suspect there's some reason certain people don't want to go there. IMO, it's very very unlikely Trump does not have NPD, and it's impossible he's "normal", however you define the word.

There's probably some truth to all that, and I'm going to try and work on it. My brother-in-law unfriended me this morning after I called him a "useful idiot".

I've mentioned this before but its disheartening watching the discussion go through the stages

1. I hate X.
2. I hate people who support X.
3. I hate people who don't hate X.
4. I hate people who don't hate X enough.

And Trump is so much of a decisive dumpster fire in a bad suit that we've reached:

5. I hate people who don't take every opportunity to say how much the they hate the people who don't hate Trump enough.

The end game of this should be a better world for all of us. Not crowing the winner in the "Who can hate Trump the most and bring it up the most" contest.

6. I'm moving to Canada if Trump is re-elected, just like Rosie, Cher, and Babs did... oh wait, they're still here. Alright, I hate them too then.

Not so. He explicitly encouraged followers to physically assault protesters who were behaving lawfully. This happened on more than one occasion.

The intelligence community? He blamed his own Nation:

Not really the same thing.

It's not clear if Trump has a history of domestic violence but it's also not clear he doesn't.

Just Revealed: Donald Trump Has A Scary History Of Domestic Violence According To His Children

Yes his ex took back the rape charges when they reached a financial agreement.

Rolling Stone: Trump’s leaked remarks about grabbing women are consistent with his history of alleged and admitted physical assaults

Michael Cohen's infamous threatening phone call: Why would Cohen need to make that last remark?

More on Trump So he encourages violence, he ignores domestic violence among his staff and there is at least some evidence he's committed domestic violence.

Ditto²

Well, that's a relief. Grabbing women by the pussy was only a 'comment'. Phew ... I was thinking he might actually have done that thing.

Well, I am digging in my heels, that's true; but, it isn't because I can't admit I'm wrong. In fact, I readily admit that I don't know enough to form my own independent conclusions; I must rely on what the consensus of experts in the field think. And in this case, I cannot side with a handful of experts who are neither following the ethics of the profession nor applying any validated methodology. They have published no peer-reviewed studies on the subject and they are in direct conflict with the current consensus as represented by the APA (both of them).

Putting aside the thorny briar patch of ethics for now, I once would have thought that it was uncontroversial that medical professionals should, first and foremost, root their practice in science-based, validated methodologies. I am shocked to find that there are some, even some in the medical community itself, who would so vigorously defend an unproven, non-scientific practice like "distant diagnosis." Now, if I'm mistaken about that, I'm ready to admit it. I don't know all the science of psychiatry and psychology. But it will take more than a few people in white coats declaring that they are right; it will take actual cites of studies, practice guidelines, etc supporting the validity and reliability of psychiatric/psychological evaluation at a distance relying solely upon public domain information. In fact, it will take development of an accepted, peer-reviewed methodology for distant diagnosis. That's just the way medicine works.

And it's not just the question of "distance diagnosis" itself. Is such a diagnosis useful for predicting future behavior? Can a psychiatrist actually say that "Candidate X is likely to launch nukes without proper justification," without ever meeting them?

Well, if alleged sexual assault is such great evidence of "dangerous mental illness," where in the heck were the shrinks back when Bill Clinton was a candidate/POTUS?

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I AGREE

A friend remarked that someone in a news report was an amputee. I turned to her, "You're not a doctor! You're totally unqualified to diagnose someone you've never met without proper training."

People do the same exact goddamn thing with Trump. They think that just because they've seen him on television, they can say label him a narcissist. It's not narcissism if he's truly the best.

I read that as blaming the diplomatic and policy errors of successive US administrations (probably he just means Obama). But sure, okay, he blamed his own Nation. So what?

The US screwed up Vietnam pretty bad. There, I said it. I blamed my own Nation. Where do we go from here?

That's not related to what I asked you. You seem to think that distancing himself from conservatives is a character flaw. I don't understand why.

IMO, if you're interested and suspect you aren't, you're confusing where one applies evidence based medicine and where one applies experience and education.

Evidence based medicine was applied to developing the DSM(hopefully), both diagnosis and treatment recommendations. It includes tests one would do to rule something in or out.

Education and experience are how one gains the skills to recognize a diagnosis or the differential and decide what to do after that.

You are dogmatically applying the in-person rule. You cannot say what one would gain in this case, because there isn't anything), we've cited some professional opinions pointing out that said in-person exam was not always required, and this was just the kind of case where the in-person exam would add nothing.

Common sense tells you that Trump would lie if you examined him in person, and that one wouldn't gain any additional insight.


A person who doesn't have experience in diagnosing a patient might erroneously try to apply some evidence based medicine principle or process when that is not where, why and how you apply it.

You know this is a non-sequitur, right? :boggled:

Not the same thing as what?

He unambiguously encouraged his supporters to beat protesters who were behaving lawfully. Saying that he hasn't been involved in "physical threats" is just wrong.

As well, he's been accused of assault by multiple women.

No, I think if someone makes a habit of it that should be evidence to that person that that particular belief system might not be the best in the world.

I am very interested in the practice of medicine because such knowledge enhances my ability to manage a medical practice. Medical pactitioners gain knowledge and experience in applying science to diagnosing and treating problems with the body. Everything they do is rooted in science. Methods that don’t stand up to scientific scrutiny are rejected. Do you think that’s fair to say?

So far so good. I agree with this.

Here is where our disconnect is and let’s see if we can resolve it. I would say that the very methods used to come up with a diagnosis or differential are also based in science. The experience and skill is developed to learn which methods are appropriate for each presentation. Can you think of one area in your professional practice where you don’t use diagnostic methods with a basis in science? I would wager that everything you do is supported by science and that as new research comes in and guidelines change, so does your practice.

Absolutely not. 1)The APA, the same organization that (we both hope) used EBM to develop the DSM, also used the latest evidence to initially develop and now reassert its support for the in-person exam. 2)There is no other method with support in the science -as imperfect as it may be, it’s all there is. I have given several things to be gained -objectivity, the fiduciary duty, etc- but you are essentially right: it isn’t for me to present that. The APA has done that already. And you know what? They may be right! Their task, then, is to gain support for these ideas by putting in the work and developing an evaluation method that is objectively better. Until then, it’s just an opinion, not a new method of psychiatric evaluation.

I don’t believe in common sense. You could make that argument about any narcissist. I am confident that skilled and experienced professionals engaged in an ongoing therapeutic relationship could use the latest methods and tools to arrive at an accurate diagnosis -even with a deceptive subject.


The problem is that there is no other method to apply. At least no method that has support in science.

Just an observation. You presented evidence of Trump’s violent nature in support of his “dangerousness,” and I observed that we could apply that to another President. I remember a lot of defense of Clinton and nothing at all from the mental health profession. Just interesting to me...

Statistical psychology has developed survey instruments scientifically designed to elicit truth from liars.

I would take the Yale group's conclusions a lot more seriously if they were informed by such instruments.

No I did not.

I merely added examples to Varwoche's list that Emily's Cat was refuting because it lacked that category of example.

As for applications to Bill Clinton, your whataboutism is off topic.

Not every comparison is “whataboutism.”


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You didn't do it while President and standing next to Ho Chi Minh at a press conference during the battle of Hue.

Otherwise, spot on.

**By the way, I don't believe you've presented a single study that the in-person interview is required. It's a professional consensus and as such, subject to challenge. It was never determined by some RCTs or anything close. So right there you don't have supporting evidence. Did you just assume it existed?

On to the rest of your post. You don't practice medicine by looking up some study about every possible presentation a patient might arrive with.

Yes, I might have an evidence based protocol for a patient presenting with abdominal pain. But if a patient presents with an arm bent in the middle where it shouldn't be, I'm not going to find a study that says said patient needs a splint and an X-ray.

And suppose the patient with abdominal pain then tells me they think they swallowed a chicken bone. Is there a study for that? Of course not. :rolleyes:

You have to put a lot of pieces together.

Say this is a little kid and the mom thinks s/he swallowed something. I do have a protocol for a young child with abdominal pain. Guess what is on it? Don't rule out something in the chest.

I have no doubt there is one or more study that says how many small kids with an abdominal complaint actually have a problem in the chest. How many doctors do you suppose go looking that up when they see a kid with a 'tummy ache'?

None! You know that because you learned that is something to consider. Know where I learned it? In my clinical in a children's hospital ED when I was in nursing school, long before I ever became a nurse practitioner.

There is no study that tells you what to do if you are following your algorithm and there is no step for what you find next. You just can't write an algorithm for any and every thing you are going to see. If you could then one wouldn't need a practitioner, you could use a computer.


Trump's symptoms are not hard to recognize, the diagnosis in his case is not complicated despite posts in this thread claiming it is. When you read that crap on the internet that a narcissistic personality disorder is hard to diagnose, it says that to prevent every Tom, Dick and Harriet from diagnosing every conceited person with narcissism.

It boggles my mind that anyone would question Trump's problem is pathologic. OMG, look at yesterday! Putin may very well have the pee tape and all kinds of incriminating financial records, but overlying that is the blatant inability of Trump to consider for even a fraction of a second that he didn't win fair and square. That eats at him.

The two things he repeats more than anything is 'no collusion' (because that would mean he didn't win fairly) and it didn't affect the outcome.

Blatantly obvious pathologic narcissism, and if you weren't going by some rule you read on the internet, you would admit it.

Maybe not but that one was.

He doesn't subscribe to "that particular belief system", he subscribes to some of the same beliefs as other people who are characterised as conservatives (by themselves and others), and doesn't subscribe to other beliefs that are characterised as conservative.

The fact that conservatives are wrong about some things doesn't mean they are wrong about all things. The same is true of liberals. The same is true of everyone.

I really, really still want to know what mechanism is in place to remove the president if he or she is obviously a totally broken loon.

There doesn't appear to be a process in place to assess the mental health of the president, therefore, if he were literally exhibiting the symptoms of paranoid delusion, how would the USA protect itself by having the president assessed psychologically? As far as I can see, there's no mechanism for this.

There doesn't appear to be a process that could be successful to remove him from office if he were a loon. I know that, technically, there is, but the grossly partisan nature of US politics makes it impossible.

The president could be psychologically broken beyond repair to the point that they were a danger to the US and to the world and there's literally nothing that could be done about it.