Donald Trump has 'dangerous mental illness', say psychiatry experts at Yale conferenc

[xjx388]

I don't think you can make a case for NPD of any poster based on this thread.

I think that's a ludicrous claim.

It's pretty easy to make a case for any given person having any given psychiatric diagnosis if we 1)Interpret everything they do through biased lenses, 2)Cherry pick their statements so as to fit criteria, 3)Start from the assumption that they must have some kind of diagnosis and 4)Ignore all standard medical procedure and ethics by practicing checklist medicine on people we have never met.

As a pure exercise without any serious intent whatsoever, here is the criteria for NPD:

Grandiosity with expectations of superior treatment from others

Fixated on fantasies of power, success, intelligence, attractiveness, etc.

Self-perception of being unique, superior and associated with high-status people and institutions

Needing constant admiration from others

Sense of entitlement to special treatment and to obedience from others

Exploitative of others to achieve personal gain

Unwilling to empathize with others' feelings, wishes, or needs

Intensely envious of others and the belief that others are equally envious of them

Pompous and arrogant demeanor

Are you saying that we can't pick certain statements from posters in this thread and make them fit into this criteria? Of course we can! With permission, I could easily demonstrate it for argument's sake.

 

[Skeptic Ginger]

Earlier, you were willing to participate in a real dollar challenge with another list member.

I'd like to offer one of my own. Regarding above, would you be willing to write your certifying body an email, asking them if you are qualified to diagnose a potential patient based on their media history and share the results with the forum?

I already posted supporting citations that basic psychiatric diagnoses were within the scope of family practice. I am certified in family practice, occupational health and infection prevention. In WA State NPs are independently licensed to practice in the areas they are certified in.

Your request is unrealistic given that is not a function of the state nursing commission (my licensing board).

I don't really care, this is a forum. It's not up to me to prove anything to anyone here though I'm pretty sure people who know me don't doubt my profession.

I will say it again, I am not the only professional who has concluded Trump has NPD. Look at the OP for Pete's sake!

If you draw a contradictory conclusion, that's your business. But you need to address all the professionals that have made public statements. Trying to make this about me is disingenuous cherry picking.

 

[Skeptic Ginger]

It's pretty easy to make a case for any given person having any given psychiatric diagnosis if we 1)Interpret everything they do through biased lenses, 2)Cherry pick their statements so as to fit criteria, 3)Start from the assumption that they must have some kind of diagnosis and 4)Ignore all standard medical procedure and ethics by practicing checklist medicine on people we have never met.

As a pure exercise without any serious intent whatsoever, here is the criteria for NPD:

Are you saying that we can't pick certain statements from posters in this thread and make them fit into this criteria? Of course we can! With permission, I could easily demonstrate it for argument's sake.

Another example of Dunning Kruger, you read the criteria in the DSM and imagine that without any context the criteria apply to anyone. It does not.

Trump does however, meet the NPD diagnostic criteria as many recognized professionals have attested to.

 

[Emily's Cat]

I think the opposite, and I up the ante by saying that given the challenge of remote diagnosing any member of this forum with any random cluster B, we can be guaranteed to get a hit. The evaluator just needs some motivation and time to read through every post, selecting the juicy bits to present as confirmatory evidence.

This is the reason remote diagnosis is considered malpractice: there's too much filtering when the presentment is captured from curated snippets versus an interactive process.

Here's an easy one: let's start with [OCPD].

In the interest of the list education, I volunteer to go first.

Oooh, oooh - do me next!

I can almost guarantee that I'll tick a lot of OCPD boxes. Probably a pile of the others PDs too.

 

[jimbob]

I didn't see anything in that list that bears relation to a medical diagnosis for NPD.

He's a bold faced liar for political gain - so's every politician in history. Nothing medically debilitating about that.

Trump's lies look different to normal politicians. Most politicians don't lie about trivial things that don't matter when they are obvious lies.

I also think there's a misunderstanding about NPD versus colloquial narcissism.

NPD isn't narcissism on steroids. There's no "if narcissim gets very severe it crosses a threshold and becomes NPD" - that's not how it works.

A key qualifying characteristic of any Cluster B is that the personality traits are causing the patient suffering. I just don't see it in this case. I can't picture him moaning, "If only I was less narcissistic, my life would be so much better, I wish I could change."

A real life example is one of my wife's patients. For some reason, his condition manifests as having to push ahead in lines. Recently, he made the mistake of crossing a fellow liner-upper who was a professional pub bouncer, and the patient got a sock in the stomach that led to surgery for internal bleeding. In terms of magnitude, this guy's practically harmless. But the inability to turn off the impulse to demonstrate his superiority has led to clear self harm and suffering, and combined with enough of the other criteria, he checks out for NPD.

There's NPD patients out there who've lost visitation rights to their children, beat their spouses and ended up in prison, lost an eye because they couldn't stand down and walk away when they've been insulted...

Meanwhile, this dude's a billionaire playboy president. I just don't see the suffering.

The trouble with the "harm" criterion is that Caligula and Nero probably weren't harmed by their behaviour until it ended up getting them killed.

Similarly, Jim Jones or David Koresh did quite well... until they didn't.



Trump's need to have more scoops ice cream than anyone else in the white house is pretty close to your wife's patient's need to be in the front of a queue.

 

[Emily's Cat]

I already posted supporting citations that basic psychiatric diagnoses were within the scope of family practice. I am certified in family practice, occupational health and infection prevention. In WA State NPs are independently licensed to practice in the areas they are certified in.

Once again, I will point out that 1) Personality Disorders aren't "basic psychiatric diagnoses" and 2) you are not certified to practice a psychiatric specialty, and there for are NOT licensed to practice mental health.

 

[xjx388]

I already posted supporting citations that basic psychiatric diagnoses were within the scope of family practice. I am certified in family practice, occupational health and infection prevention. In WA State NPs are independently licensed to practice in the areas they are certified in.

Your request is unrealistic given that is not a function of the state nursing commission (my licensing board).

I don't really care, this is a forum. It's not up to me to prove anything to anyone here though I'm pretty sure people who know me don't doubt my profession.

I will say it again, I am not the only professional who has concluded Trump has NPD. Look at the OP for Pete's sake!

If you draw a contradictory conclusion, that's your business. But you need to address all the professionals that have made public statements. Trying to make this about me is disingenuous cherry picking.

Blutoski, me, EC . . . none of us has made this about you. You introduced your expertise so you made it about you. You are trying to "win the argument" by saying you are an expert so we should listen to you. I think you should put up or shut up, in this case. The Nursing Board of Washington is not who you should be emailing for an answer. They license you to practice within the scope of practice of the certification you have. You have said that you are an FP APRN so that means you need an answer from the certifying body that you went through: the AAPN or the ANCC most likely. The question for them is: Does an FNP have the expertise to diagnose mental health conditions in people they have never met? I don't think you'll like the answer.

But fundamentally, you are correct: this isn't about you or even what the scope of practice of an FNP should be. This is about the standards of practice and ethics of the mental health profession. The official positions are clear.

 

[blutoski]

Trump's lies look different to normal politicians. Most politicians don't lie about trivial things that don't matter when they are obvious lies.

Pretty vague. Sounds like diagnosis through anecdote and opinion.

The trouble with the "harm" criterion is that Caligula and Nero probably weren't harmed by their behaviour until it ended up getting them killed.

Similarly, Jim Jones or David Koresh did quite well... until they didn't.

Sorry, not sure what you're saying... are we diagnosing through history books now?

Or is this meaning that OK the diagnosis has that criteria but you disagree with it? (diagnosing through personal criteria, not DSM?)

 

[blutoski]

I already posted supporting citations that basic psychiatric diagnoses were within the scope of family practice.

And I think we're disputing that NPD is one of them.

Easy to clear up, we can just send an email. I'm willing to wager a coke.

 

[blutoski]

Oooh, oooh - do me next!

I can almost guarantee that I'll tick a lot of OCPD boxes. Probably a pile of the others PDs too.

OCPD pretty much has "typical skeptic" written all over it.

"Loves to argue - can't lose an argument." Check, check, check, aaaaand check.

Yet, we're probably not pathological. Cluster B Diagnosis is just too contextual.

 

[xjx388]

Another example of Dunning Kruger, you read the criteria in the DSM and imagine that without any context the criteria apply to anyone. It does not.

Why not? That is exactly what you are doing here: insisting that since you can demonstrate Trump checks all the criteria boxes he must have NPD. You add only one wrinkle: "I am a medical professional so I must be more right than you."

You are using "Dunning-Kruger" to basically call me stupid -an ad hom and misapplication of the term. I have never represented myself as anything other than a layman who is using the standards of the profession which are publicly available. I'm going to use Dunning-Kruger much more precisely: You are an FNP who thinks your license to practice medicine means you are expert in all facets of medicine. This is true illusory superiority. Your training and certification is not in psychiatry. You don't have practice experience in psychiatry. You should know enough to know how much you don't know. So tell us again how expert you are in diagnosing psychiatric conditions . . .

Trump does however, meet the NPD diagnostic criteria as many recognized professionals have attested to.

And many, many more have either remained silent or said that they don't have enough information. The organization involved in training and representing the profession has issued a very clear refutation of your position. Sorry, but your insistence that the vast majority of the mental health profession is wrong is not very convincing.

 

[jimbob]

Trump's lies look different to normal politicians. Most politicians don't lie about trivial things that don't matter when they are obvious lies.

Pretty vague. Sounds like diagnosis through anecdote and opinion.

True - I am an engineer not psychologist or psychiatrist. However the easiest way to predict what Trump will say is to ignore the truth, but just think what someone with no self-awareness and a massive sense of entitlement would say. "I grabbed her by the pussy" (almost certainly true). "I had the biggest crowd" (obvious lie). Telling the Economist magazine that he had just come up with the term "priming the pump" (laughably wrong)

The trouble with the "harm" criterion is that Caligula and Nero probably weren't harmed by their behaviour until it ended up getting them killed.

Similarly, Jim Jones or David Koresh did quite well... until they didn't.

Sorry, not sure what you're saying... are we diagnosing through history books now?

Or is this meaning that OK the diagnosis has that criteria but you disagree with it? (diagnosing through personal criteria, not DSM?)

Not diagnosing through history books, but I'm making the point that their behaviours eventually *did* cause them harm, but until that time, their "skewed view of the world" had caused them to behave in a certain way.

The fact that it didn't cause them problems earlier, is a problem with the definition in my view. That was what I was highlighting. Not diagnosing historical figures with a particular condition, but choosing notoriously dangerously odd historical figures who had been protected by their position.

 

[Skeptic Ginger]

Blutoski, me, EC . . . none of us has made this about you.

Yes you have, when you stopped including other professionals' opinions and only argued against mine as if that was the only opinion Trump has NPD..

... The question for them is: Does an FNP have the expertise to diagnose mental health conditions in people they have never met? I don't think you'll like the answer.

You may not like the answer, but it has been addressed in this thread.

But fundamentally, you are correct: this isn't about you or even what the scope of practice of an FNP should be. This is about the standards of practice and ethics of the mental health profession. The official positions are clear.

Yeah, they are. You just choose to only look at some of those positions and you ignore the positions you don't like.

 

[blutoski]

True - I am an engineer not psychologist or psychiatrist. However the easiest way to predict what Trump will say is to ignore the truth, but just think what someone with no self-awareness and a massive sense of entitlement would say. "I grabbed her by the pussy" (almost certainly true). "I had the biggest crowd" (obvious lie). Telling the Economist magazine that he had just come up with the term "priming the pump" (laughably wrong)

Yep. Lies like a sidewalk. I diagnose "liar," but not necessarily "NPD".

Not diagnosing through history books, but I'm making the point that their behaviours eventually *did* cause them harm, but until that time, their "skewed view of the world" had caused them to behave in a certain way.

The fact that it didn't cause them problems earlier, is a problem with the definition in my view. That was what I was highlighting. Not diagnosing historical figures with a particular condition, but choosing notoriously dangerously odd historical figures who had been protected by their position.

Right, and this highlights the reason we don't diagnose through media. Your knowledge of these historical figures is filtered, you have no idea what their private thoughts or motives were, or even if they had consequences prior to their deaths, so maybe they did, right?

A good example is Nero, who is actually a case study in adolescent depression. He was a first century "emo" kid. Multiple suicide attempts, constantly writing prose about how lonely he was and how nobody liked the real him. He wasn't killed, he committed suicide.

But here's the thing... and this relates to an earlier post you had about how rich people can be depressed... the diagnostic interest is whether a person's depression is specifically caused by the narcissism. Not whether it's concurrent due to an unrelated cause.

Let's assume that Trump is failing at one of his goals. Take Obamacare Repeal, for example. Is he unable to accomplish this because of his narcissism? Or is it because it's flat out difficult? Did the Senate fail to produce a bill because there was no political route at the moment, or because they don't like Trump's attitude and spiked it to spite him? I don't see the necessary connections to say that anything I would speculate as a failure (and we're also making assumptions about what he considers a success or failure - what if his goals are to enrich his family, and all this presidenting is a pretense to loot?)

 

[Skeptic Ginger]

And I think we're disputing that NPD is one of them.

Easy to clear up, we can just send an email. I'm willing to wager a coke.

IOW present inappropriate evidence. (I told you, that is not the nursing commission's function.)

As for disputing my scope of practice, what are you basing your assertion on? Like I said, I posted supporting evidence that recognizing/diagnosing basic psychiatric disorders was indeed within the scope of family practice. Why you think NPD is so complex is another unsupportable assertion you've made.

 

[jimbob]

Yep. Lies like a sidewalk. I diagnose "liar," but not necessarily "NPD".





Right, and this highlights the reason we don't diagnose through media. Your knowledge of these historical figures is filtered, you have no idea what their private thoughts or motives were, or even if they had consequences prior to their deaths, so maybe they did, right?

A good example is Nero, who is actually a case study in adolescent depression. He was a first century "emo" kid. Multiple suicide attempts, constantly writing prose about how lonely he was and how nobody liked the real him. He wasn't killed, he committed suicide.

But here's the thing... and this relates to an earlier post you had about how rich people can be depressed... the diagnostic interest is whether a person's depression is specifically caused by the narcissism. Not whether it's concurrent due to an unrelated cause.

Let's assume that Trump is failing at one of his goals. Take Obamacare Repeal, for example. Is he unable to accomplish this because of his narcissism? Or is it because it's flat out difficult? Did the Senate fail to produce a bill because there was no political route at the moment, or because they don't like Trump's attitude and spiked it to spite him? I don't see the necessary connections to say that anything I would speculate as a failure (and we're also making assumptions about what he considers a success or failure - what if his goals are to enrich his family, and all this presidenting is a pretense to loot?)

I think the last paragraph is the "Trump might be playing 4D chess" argument. I find that implausible.

My view is that Trump's behaviour is so odd that it raises warning flags, and that he should be subjected to an examination to see whether he is fit for office.

Whilst I accept that clinical psychologists would not diagnose someone without an examination, criminal psychologists have to do something pretty akin to this, based on the evidence they have available, which would be far less than the evidence we have in the case of Trump.

 

[Skeptic Ginger]

Yep. Lies like a sidewalk. I diagnose "liar," but not necessarily "NPD".

Right, and this highlights the reason we don't diagnose through media. Your knowledge of these historical figures is filtered, you have no idea what their private thoughts or motives were, or even if they had consequences prior to their deaths, so maybe they did, right?

You don't seem to be looking at the totality of the evidence, something that has been addressed in the thread more than once.

A good example is Nero, who is actually a case study in adolescent depression. He was a first century "emo" kid. Multiple suicide attempts, constantly writing prose about how lonely he was and how nobody liked the real him. He wasn't killed, he committed suicide.

But here's the thing... and this relates to an earlier post you had about how rich people can be depressed... the diagnostic interest is whether a person's depression is specifically caused by the narcissism. Not whether it's concurrent due to an unrelated cause.

Depression is not the dysfunction Trump has evidence of.

Let's assume that Trump is failing at one of his goals. Take Obamacare Repeal, for example. Is he unable to accomplish this because of his narcissism? Or is it because it's flat out difficult? Did the Senate fail to produce a bill because there was no political route at the moment, or because they don't like Trump's attitude and spiked it to spite him? I don't see the necessary connections to say that anything I would speculate as a failure (and we're also making assumptions about what he considers a success or failure - what if his goals are to enrich his family, and all this presidenting is a pretense to loot?)

You're looking at the evidence all wrong.

Trump claims he has an Obama care replacement plan, says it over and over during his campaign. When the time comes to present his plan, he shifts into denial and insists that McConnell and Ryan present their plan. They don't have one either. No plan is passed. Trump now says it's the GOP that failed and despite irrefutable evidence Trump had claimed he had a plan when he didn't, it's as if he simply cannot accept that he ever said that. You can show a video to him where he said it, he still can't see it.

Now one might say this was no different from typical campaign promises and deflecting criticism. But when you look at Trump repeating this same pattern again and again you see that his behavior crosses into the pathologic side of the continuum. His denial is extremely pathologic as there is no evidence Trump can control this behavior. It's not even clear that he recognizes his behavior, I suspect he doesn't. That is the typical lack of insight people with mental illnesses often have.

Take his insistence more people were at his inauguration than were at Obama's. He didn't just insist it and claim the park department images were taken at the wrong time. He contrived a conspiracy against him by the park employees. That is paranoia associated with mental illness. Then he had images
of different angles appearing to show a fuller attendance blown up and framed. He placed them on the walls in the White House and pointed them out to reporters. He had Spicer go out and make outright false statements in the first press briefing. He brings up his crowd attendance claiming it set records months after the inauguration. That is obsessive preoccupation with that crowd size. There is little to no political gain from that big lie except to con his shrinking base into agreeing the mainstream news is fake news.

There is no evidence Trump knows he's lying about the crowd attendance, again, his pattern is consistent. Again and again he repeats lies inflating his accomplishments and popularity.

 

[xjx388]

<snip>
Not diagnosing through history books, but I'm making the point that their behaviours eventually *did* cause them harm, but until that time, their "skewed view of the world" had caused them to behave in a certain way.

The fact that it didn't cause them problems earlier, is a problem with the definition in my view. That was what I was highlighting. Not diagnosing historical figures with a particular condition, but choosing notoriously dangerously odd historical figures who had been protected by their position.

There's a difference between people who make bad decisions and have a bad outcome and people who have bad outcomes because of a mental illness.

 

[blutoski]

You don't seem to be looking at the totality of the evidence, something that has been addressed in the thread more than once.

Yep, but neither are you. Neither did these Yale Docs. They're going by filtered curated media snippets, not "the totality of the evidence." Specifically, they're omitting personal interview results. Nobody's going by the totality of the evidence. Thus my proposal that we advocate for a proper examination.

Depression is not the dysfunction Trump has evidence of.

He doesn't seem depressed at all! Maybe no consequences, then! No consequences, no NPD.

As five minutes ago, you didn't think Nero did either, because your resources were incomplete. There was an information gap that led to an inaccurate diagnosis. That's why I unpacked your example, I thought it proved my point.

 

[xjx388]

Yes you have, when you stopped including other professionals' opinions and only argued against mine as if that was the only opinion Trump has NPD..

You are the one in this thread representing the position in the OP and using your credentials to do it. But no one brought up your credentials except you.

You may not like the answer, but it has been addressed in this thread.

No it hasn't. You cited the Washington Board of Nursing that licenses you to practice. You haven't cited anything from the credentialing body that issued your certificate. And you certainly haven't cited anything that says a FNP has the expertise to diagnose people they have never met.

Yeah, they are. You just choose to only look at some of those positions and you ignore the positions you don't like.

No. You are dismissing the APA based only on the idea that you and a handful of other professionals disagree with them.