Cont: Donald Trump has 'dangerous mental illness' say psychiatry experts at Yale... Pt 3

[xjx388]

I will concede that Gilligan was talking about violence. He also gives a good case for his fear that Trump exhibits tendencies toward it just before the quote you provided:

I don't know that it's a good case. Dr. Gilligan is an expert in violence, an expertise gained by his years of working with violent criminals. Trump is catagorically different from the type of patient Dr. Gilligan has worked with. He hasn't done any research on people like Trump, he hasn't worked with patients like Trump and he certainly hasn't ever worked with Trump himself.

Let's take the first item in the list: Trump reportedly asked why we couldn't use nukes if we had them. This story is solely sourced to an unnamed source NBC's Joe Scarborough spoke to before Trump was elected:

“Several months ago, a foreign policy expert on the international level went to advise Donald Trump. And three times [Trump] asked about the use of nuclear weapons. Three times he asked at one point if we had them why can’t we use them,” Scarborough said on his “Morning Joe” program.

That does not sound to me like ample evidence to base a sound professional opinion on. It is, however, perfectly fine for a concerned citizen to speak out -there's no need to invoke the medical profession to do so.

I agree partly. Yes, each patient must be assessed individually, but you are minimizing the use of the DSM as a diagnostic tool. That checklist was created after input from many mental health professionals after years of research.

I'm not minimizing it; I'm putting it in it's proper place -it's a tool for professionals to use as a part of arriving at a diagnosis. One tool of many that includes semi-structured interviews, review of medical records, etc. When used as part of a complete assessment it's a well validated tool. When it's used as the only thing you are looking at, not so much.

That alleged motivation by the authors is an opinion, not a fact. They are not "attacking politicians". They are concerned with the danger they believe Trump poses.

It's criticism of a politician in order to convince people to remove that politician from office. It is by it's very nature a political attack.

 

[xjx388]

Then quote him, don't simply paraphrase him.

Simple!

Been done many times in the thread. Most recently about 3 or 4 posts up.

Yes, I'm familiar with it. No, I don't agree with it.

You don't agree with the Goldwater rule? That's fine. Your disagreement with the rule doesn't change the fact that it's a rule and that the Yale Group is in violation of it. The rule has been challenged and upheld by the APA so that's the relevant thing here.

The knowledge that professional psychiatrists think Trump is dangerously mentally ill.

That's a mere restatement of terms. What is gained by such knowledge? What are we supposed to do with that?

What utter rubbish.

What useful information do you derive from a diagnosis? Are you going to treat the President?

 

[Cabbage]

Been done many times in the thread. Most recently about 3 or 4 posts up.

I'll grant you that he's concerned with dangerous violence tendencies in Trump. In no way does that imply that he has no other concerns (like the ones I mentioned).

You don't agree with the Goldwater rule? That's fine. Your disagreement with the rule doesn't change the fact that it's a rule and that the Yale Group is in violation of it. The rule has been challenged and upheld by the APA so that's the relevant thing here.

'K. On the other hand, that's irrelevant to the question of what I consider (un)ethical. But thanks for trying.

That's a mere restatement of terms. What is gained by such knowledge? What are we supposed to do with that?

Haven't we been through this aspect of the discussion before? As long as there is the potential for more Americans to become aware of the danger of Trump, I consider that a gain.

What useful information do you derive from a diagnosis?

For examples: If a patient receives a diagnosis that he has a poor heart, he has the useful information that he should go easier in his lifestyle: Eat more healthy. Moderate physical activity.

If someone close to me is diagnosed with borderline personality disorder, the mere fact of that useful information allows me to be more cautious and aware around the individual with the correlation for violent behavior.

Seriously, I can't believe you need to ask this question. Really.

Are you going to treat the President?

Do you think I should? Someone certainly should, and not one of his typical Kiss-Ass-Quacks, neither.

I'll get right on it, if you need me to.

 

[Skeptic Ginger]

Remember when fuelair would regularly go off on these graphically violent sado-sexual revenge fantasies? And no amount of remonstration or sanction could convince him to moderate that behavior?

Did you think he really had a dangerous mental illness, and might explode into actual violence at any moment? ...

One allegation, thirty years ago, later withdrawn. Serious enough in its own right, but definitely not an escalating trend of violent outbursts by President Trump.

I don't suppose you see the contradiction there.

Your analogy is a fail.

Your example of fuelair has nothing in common with the issues here.

 

[xjx388]

I'll grant you that he's concerned with dangerous violence tendencies in Trump. In no way does that imply that he has no other concerns (like the ones I mentioned).

The only concerns we are ...uh, concerned with are those that he has actually made a part of his professional opinion.

'K. On the other hand, that's irrelevant to the question of what I consider (un)ethical. But thanks for trying.

No problem. The answer to the question I asked, it seems, is: “Yes they breached the ethical code, but I’m ok with that.”

And that’s the difference between us. I don’t know why you think that way because you haven’t told me. I can only say that I strongly disagree because adhering to an ethical code is fundamental to ensuring good practice of medicine. If a professional breaches ethics, how can we be sure they are actually acting professionally? I’m sure you would have a problem with ethical breaches in most other medical contexts (Doctors dating patients? Breaking confidentiality? Advocating unproven treatments?), so I’m not sure what makes this different. Or maybe you don’t think ethics in medicine is a big deal?


Haven't we been through this aspect of the discussion before? As long as there is the potential for more Americans to become aware of the danger of Trump, I consider that a gain.

For examples: If a patient receives a diagnosis that he has a poor heart, he has the useful information that he should go easier in his lifestyle: Eat more healthy. Moderate physical activity.



If someone close to me is diagnosed with borderline personality disorder, the mere fact of that useful information allows me to be more cautious and aware around the individual with the correlation for violent behavior.

There, you are talking about situations where someone has been personally diagnosed in the traditional way by a professional who has spent time assessing the person and going through the diagnostic process. That isn’t what we are talking about here. In those situations, a diagnosis is useful for treatment.

And as to your second example, the diagnosis itself isn’t telling you anything, if they really are close to you. You’ve already observed their behaviors and know that you have to be wary. The diagnosis will facilitate their treatment and that’s about it.

You’ve observed Trump. You already came to a conclusion about him before the Yale Group existed. I’m quite sure you didn’t vote for him. What did the Yale Group tell you that fundamentally changed your view of him?

Seriously, I can't believe you need to ask this question. Really.

Uh...because in order to have a conversation I need to find out what you think and the best way to do that is ask?

Do you think I should? Someone certainly should, and not one of his typical Kiss-Ass-Quacks, neither.



I'll get right on it, if you need me to.

Exactly, you aren’t treating him so there’s no useful information in a diagnosis for you.

 

[Stacyhs]

We've gone round and round and round on this issue ad nauseam. I don't really give a **** about the Goldwater rule, whether or not Lee's book is 'ethical', whether or not Trump has been seen in person by a mental health professional, whether he is going to be violent or whether he wears pink undies with lace. I do know what I've seen of the man and what his behavior leads me to conclude is that there is something seriously wrong with him. He is not stable. He is an extreme narcissist who can never, ever admit he's wrong, thinks he's above the law, who never learns because he thinks he knows better than anyone else, who has the emotional maturity of a child, is a bully and pathological liar. That makes him unfit to hold the most powerful position in the world. People here can continue to nit pick about semantics and get all huffy about 'ethics' till the cows come home. It doesn't change what I see and why over 70,000 mental health officials are so concerned about that they signed a petition warning about how dangerous he is.

 

[Skeptic Ginger]

We've gone round and round and round on this issue ad nauseam. I don't really give a **** about the Goldwater rule, whether or not Lee's book is 'ethical', whether or not Trump has been seen in person by a mental health professional, whether he is going to be violent or whether he wears pink undies with lace. I do know what I've seen of the man and what his behavior leads me to conclude is that there is something seriously wrong with him. He is not stable. He is an extreme narcissist who can never, ever admit he's wrong, thinks he's above the law, who never learns because he thinks he knows better than anyone else, who has the emotional maturity of a child, is a bully and pathological liar. That makes him unfit to hold the most powerful position in the world. People here can continue to nit pick about semantics and get all huffy about 'ethics' till the cows come home. It doesn't change what I see and why over 70,000 mental health officials are so concerned about that they signed a petition warning about how dangerous he is.

Nominated.

 

[The Great Zaganza]

People being selected for positions that require decision making of vast consequence are not discriminated against for having mental illnesses; they are discriminated for not being exceptional at dealing with stress, distraction, lack of information and emotional impact.

It is utterly bizarre to claim that we cannot ask more of the President in terms of competency for the job than we could for a Wallmart worker stacking shelves.

 

[xjx388]

We've gone round and round and round on this issue ad nauseam. I don't really give a **** about the Goldwater rule, whether or not Lee's book is 'ethical', whether or not Trump has been seen in person by a mental health professional, whether he is going to be violent or whether he wears pink undies with lace. I do know what I've seen of the man and what his behavior leads me to conclude is that there is something seriously wrong with him. He is not stable. He is an extreme narcissist who can never, ever admit he's wrong, thinks he's above the law, who never learns because he thinks he knows better than anyone else, who has the emotional maturity of a child, is a bully and pathological liar. That makes him unfit to hold the most powerful position in the world. People here can continue to nit pick about semantics and get all huffy about 'ethics' till the cows come home. It doesn't change what I see and why over 70,000 mental health officials are so concerned about that they signed a petition warning about how dangerous he is.

I was with you until that bit about 70k mental health officials -that part simply isn’t true. Otherwise, bravo! You have summed up my position quite well when it comes to my view of Trump. Where I disagree is the importance of ethics.

I’m getting huffy about ethics because I manage doctors. It is very important to me that ethics remain a cornerstone of the profession. From a societal view, I would think we all want ethics in medicine. What the Yale Group is doing is a gross violation of ethics for all the reasons we’ve gone round and round about. I can’t understand why so many here fight me on that point.

 

[xjx388]

People being selected for positions that require decision making of vast consequence are not discriminated against for having mental illnesses; they are discriminated for not being exceptional at dealing with stress, distraction, lack of information and emotional impact.

If that were true, Trump wouldn’t have been elected.

It is utterly bizarre to claim that we cannot ask more of the President in terms of competency for the job than we could for a Wallmart worker stacking shelves.

You are right, it would be bizarre for someone to make that claim.

 

[3point14]

It's criticism of a politician in order to convince people to remove that politician from office. It is by it's very nature a political attack.

In what way would it look different if it wasn't politically motivated?

 

[theprestige]

In what way would it look different if it wasn't politically motivated?

It would make sense, for one thing.

 

[3point14]

It would make sense, for one thing.

That's subjective.

Is there anything at all that the accusers could say that would convince you and XJ that this is not political?

I only ask, because if there isn't, then any discussion with either of you is pointless.

 

[xjx388]

In what way would it look different if it wasn't politically motivated?

That's subjective.

Is there anything at all that the accusers could say that would convince you and XJ that this is not political?

I only ask, because if there isn't, then any discussion with either of you is pointless.

The truth is, this particular situation would not look at all different if it were a sincere concern. It's the inability of the lay audience to tell the difference between a political attack and a sincere concern that is a core problem.

It's kind of like when a doctor recommends a treatment that doesn't have good science behind it. Is the doctor recommending it because he truly believes in the treatment or because he makes money off of it? The patient isn't equipped to tell the difference.

However, I can see a couple of scenarios in which mental health professionals can and should speak out:

1)They speak as citizens without any of the trappings of their profession. Sure, their expertise and experience will inform what they say, but they should leave out any mention of diagnosis or dangerous mental illness. Include a clear disclaimer -something like, "I've never met him and I'm not diagnosing him but I have to speak out as a citizen . . ." Dr. Francis almost hits the mark but his "He's not mentally ill; he's the worst person ever," schtick is a bit over the top.

2)His actual therapist breaches confidentiality because Trump has spoken in session about his desire to nuke NK/Syria/wherever, his desire to purge certain ethnicities, a threat to shoot someone on 5th Avenue to see if he still has support, etc -actual specific dangers. I could see other professionals rallying in support. Then it would be based on sound medical practice and invoke a true Duty to Warn as spelled out by law.

 

[3point14]

The truth is, this particular situation would not look at all different if it were a sincere concern. It's the inability of the lay audience to tell the difference between a political attack and a sincere concern that is a core problem.

Do you count yourself as one of the 'lay audience' that you mention?

 

[Cabbage]

It would make sense, for one thing.

It doesn't make sense to you that Trump just might be mentally ill?????

 

[theprestige]

That's subjective.

You're asking what would convince me it isn't political. Obviously that's a question that can only be answered by my subjective judgement.

For example, the "duty to warn" argument doesn't make sense to me in this context. The real "duty to warn" is a narrowly-scoped legal exception to the legal requirement for medical confidentiality. It applies when a medical professional has reason to believe their patient poses an imminent risk to themselves or others. It's so that law enforcement can act immediately to prevent tragedy.

It doesn't make sense here. It's inappropriate here. In my opinion, it's being used to try to paper over the ethical breach of going public with what should be confidential patient information. There is no imminent danger. There is no public safety objective that depends on revealing this information for immediate police action.

Either the Yale group doesn't know what the duty to warn actually is, in which case they're bad doctors; or they do know, but are misusing it here on purpose, which makes them evil doctors.

That's just one example. The call for a 25th Amendment solution, the citation of the "what good are nukes" anecdote as medical evidence, and others, all signal that this is an unserious and unethical effort.

Is there anything at all that the accusers could say that would convince you and XJ that this is not political?

I only ask, because if there isn't, then any discussion with either of you is pointless.

These particular accusers? Probably not. I don't think they have standing to make the kinds of medical accusations they're making.

If a doctor who was actually treating Trump believed the president posed an imminent risk to himself and others, consistent with the actual letter and spirit of the duty to warn, and issued that warning directly to the Secret Service, I'd probably take it seriously.

---

I'd take the Yale group more seriously if, instead of a book, they'd published peer-reviewed articles citing specific data sets and methodologies for their novel techniques of remote diagnosis.

 

[xjx388]

Do you count yourself as one of the 'lay audience' that you mention?

Of course. And I don't know for sure if it's a sincere concern or a political attack. It looks and sounds, to my eyes and ears, like a political attack, the same kinds of things being said in other threads and media pundit opinion pieces, just with a long white coat lending it more gravitas.

I do know, because of my position and research on the subject, that medical ethics and standards of practice are important to the profession. I also know that the professionals here aren't following either. That leans me more to the political attack side than the sober analysis side.

 

[3point14]

You're asking what would convince me it isn't political. Obviously that's a question that can only be answered by my subjective judgement.

Thanks.

That leaves me believing you're utterly unconvincable. regardless of any current or new evidence.

 

[3point14]

Of course.

Then how are you making your judgement? If you are, self confessedly one of the lay audience, about which you say this:

inability of the lay audience to tell the difference between a political attack and a sincere concern that is a core problem.

How are you managing to discern the difference between a sincere concern and a political attack when you put yourself in the group of people that you say are unable to tell the difference between a political attack and a sincere concern?