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

[Skeptic Ginger]

I posted this in the COVID thread but it belongs here too.

GZERO World With Ian Bremmer
Preparing for the Pandemic: The Window Is Closing
SEASON 2, EPISODE 38
Pulitzer Prize-winning writer Laurie Garrett talks about mitigating the effect of COVID-19.

This morning.

Garrett said in all their pandemic disease simulations, never did they consider one where the US ignored the outbreak for weeks then addressed it with a confusing and frequently changing plan.

IOW, how do you plan a pandemic simulation when the leader of the free world is mentally ill?

 

[Skeptic Ginger]

I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trump’s Mental State

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.
Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither). ....

IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.

It was interesting skimming through part one of this thread.

 

[Cabbage]

I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trump’s Mental State

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.

Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither). ....


IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.

It was interesting skimming through part one of this thread.

Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

 

[Belz...]

Dr. Lee weighs in:

Mental health professionals have been warning for years that Trump's mental health issues would lead to such a dire situation.

https://www.salon.com/2020/03/23/dr...alth-pandemic-thats-making-coronavirus-worse/

I just realised that this thread was started three years ago.

Where has my life gone?

 

[Bob001]

I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trump’s Mental State
IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.
....

Also from that letter:

Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers.
His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.

Doc Frances is not a Trump defender. I think his point is that Trump's behavior is a deliberate choice because it gets him what he wants, despite its impact on everyone else. I wonder if the definition of "mental illness" is too broad to be useful in these circumstances; saying someone does something because they are mentally ill in a sense diminishes their responsibility. Frances says his behavior is intentional.

In a CNN interview, Frances said this:

"Calling Trump crazy hides the fact that we’re crazy for having elected him and even crazier for allowing his crazy policies to persist.”

He added, “Trump is as destructive a person in this century as Hitler, Stalin, and Mao were in the last century. He may be responsible for many more million deaths than they were. He needs to be contained, but he needs to be contained by attacking his policies, not his person."

https://thehill.com/homenews/media/...rump-may-be-responsible-for-many-more-million

 

[Skeptic Ginger]

Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

It was asinine. IMO (of course) in some bizarre attempt to not malign the mentally ill, he thought we we saying all that evil in Trump made him a horrible person but not a mentally ill person. It was some kind of denial (again IMO) that just because a person fit all the criteria for pathologic narcissism didn't mean his narcissism was representative of mental illness.

I think we are well past that now. Crossing from simple grandiosity into full recreating of reality in Trump is evidence of mental illness.

I imagine if asked Dr Frances would double down in self preservation but I wold like to see if that is the case.

 

[Skeptic Ginger]

Also from that letter:


Doc Frances is not a Trump defender. I think his point is that Trump's behavior is a deliberate choice because it gets him what he wants, despite its impact on everyone else. I wonder if the definition of "mental illness" is too broad to be useful in these circumstances; saying someone does something because they are mentally ill in a sense diminishes their responsibility. Frances says his behavior is intentional.

In a CNN interview, Frances said this:

https://thehill.com/homenews/media/...rump-may-be-responsible-for-many-more-million

Again, what does this mean: "it gets him what he wants"? There are more than a few people whose manipulative behavior is a prominent feature of their mental illness. So if the person is successful at manipulation, that's evidence they aren't mentally ill? I've met a few people with a pathologic paranoid personality disorder that were very convincing.

Maybe the DSMV should start off the personality disorders with 'must be failing to get through life' for said syndromes to apply.

 

[Stacyhs]

Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

Frances is not necessarily referring to only monetary rewards. Trump's behavior has been 'rewarded' by getting him the attention he craves, the adulation, the social status, the power, etc. It got him the presidency.

 

[Skeptic Ginger]

Frances is not necessarily referring to only monetary rewards. Trump's behavior has been 'rewarded' by getting him the attention he craves, the adulation, the social status, the power, etc. It got him the presidency.

Doesn't change the fact mentally ill people can be successful, that doesn't make them not mentally ill.

Frances made it very clear, he thought if one explained Trump's evil behavior as the result of mental illness, we maligned the real mentally ill.

 

[Stacyhs]

Doesn't change the fact mentally ill people can be successful, that doesn't make them not mentally ill.

Frances made it very clear, he thought if one explained Trump's evil behavior as the result of mental illness, we maligned the real mentally ill.

I agree. I was just addressing Cabbage's post where he, I think, misunderstood what Frances was saying.

 

[Cabbage]

Frances is not necessarily referring to only monetary rewards. Trump's behavior has been 'rewarded' by getting him the attention he craves, the adulation, the social status, the power, etc. It got him the presidency.

I wasn't implying he was referring to only monetary rewards. I was merely illustrating the absurdity of the claim.

 

[jimbob]

I wonder if Dr Frances will admit he was wrong yet?

NYT letter to the editor: An Eminent Psychiatrist Demurs on Trump’s Mental State

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.
Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither). ....

IMO Trump's imaginary world goes beyond grandiosity, self-absorption and lack of empathy, crossing the line into mental illness.

It was interesting skimming through part one of this thread.

His preferred definition does make sense on one level, but is also pretty useless.

Nero demonstrated pretty much all the characteristics of someone with NPD. For example winning every event in the Olympics.

Eventually his behaviour led to his assassination, so at that time, he fitted Dr Frances' criteria for mental illness.

However,one could argue that he hadn't been harmed by his behaviour right up to the time he was deposed.

In which case, we would be in no better a position than the citizens of Rome, in being unable to call Nero mad, until he was deposed.

Similarly, if someone's mental state drives them to take risks - it seems odd to say that they are only mentally ill if the hazard they're risking actually harms them. Hypothetically, someone's mental state could drive them to take part in Russian roulette, say from a sense of invulnerability, and they'd be likely to survive. By Dr Frances' reckoning, they wouldn't meet the definition of mentally ill, unless they lost.

 

[jimbob]

Maybe I'm reading that wrong, but that just sounds asinine. To me, that means if I reward anyone with, say, $10,000 for whatever issues they have, they are no longer mentally ill, simply because they were rewarded for it. Absurd.

From an earlier part of the thread:

Yes, but the examples I gave, their behaviour was abnormal, and it eventually caused them problems (Nero included).

The thing was that there was a threshold, mostly of time before which their same behaviour and same underlying ... worldview hadn't caused problems, although the changes were outwith them.

If I believe a magic pixie tells me what cards to pick, and I gamble and win, and then I gamble and lose everything, I was still deluded at the start, even though I actually benefited from it.

I can see why mental illness is defined as causing harm or distress to the subject, but there are sufficient situations where I would say that such a definition is missing something, which a more colloquial definition of "mad" is not.

Did the Yorkshire Ripper suffer harm or distress until he was caught?

 

[Skeptic Ginger]

It's annoying to me the news media is reporting on Trump's rosy timeline as if it's a real thing and not a fantasy thing. They do follow with the experts contradicting Trump's fantasy.

I just wish they would call it what it is, a Trump fantasy.

 

[xjx388]

I just realised that this thread was started three years ago.

Where has my life gone?

No it does not. That's idiotic. I don't care if the guy with the STD doesn't want to tell his sex partners. He can't do that.

I agree; he has an ethical obligation to inform all his partners. His doctor usually does not.

No one moved any goal post. You don't have enough knowledge to recognize STDs and HIV are treated the same as far as partner notification goes.

No they aren’t, at least not from the doctor’s perspective. There are often mandatory partner notification laws in the case of HIV, but not other STDs. In Texas, we can disclose HIV status to the spouse, but we don’t have to; the State can do it as part of the reporting process. We can’t notify spouses for other STDs but we can refer to the State and they can help with partner tracing and notification.

So you'd let an exposed person go un-notified if the legislators in all their practicing medicine without a license wisdom wrote a flawed law?

Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.



Here's your problem. You seem to think there are laws with all the little details on how a medical provider should do this or that. There are no such laws. They would be impossible to write.

So guess what? It's up to the provider. We went around on this at the beginning when you tried to tell me what my scope of practice was. In this state nurse practitioners are independent medical providers. It's up to me to know what my scope of practice is. The details are not spelled out in the law.


You didn't appear to recognize the ethical dilemma in prescribing placebos.

Your posts reflect one who is very poorly informed about the difference between ethics, medical judgement and law.[/QUOTE]



Holy ****, man....

 

[xjx388]

I don’t understand what happened with the above post. I only meant to respond to Belz with “Holy ****, man...”

 

[Skeptic Ginger]

I agree; he has an ethical obligation to inform all his partners. His doctor usually does not.
No they aren’t, at least not from the doctor’s perspective. There are often mandatory partner notification laws in the case of HIV, but not other STDs. In Texas, we can disclose HIV status to the spouse, but we don’t have to; the State can do it as part of the reporting process. We can’t notify spouses for other STDs but we can refer to the State and they can help with partner tracing and notification.

Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.

You don't see the problem claiming that last sentence while denying said providers can recognize when 'duty to warn' supercedes the ethical positions you seem to think are inviolable?

Here's your problem. You seem to think there are laws with all the little details on how a medical provider should do this or that. There are no such laws. They would be impossible to write.

This is a straw man.

So guess what? It's up to the provider. We went around on this at the beginning when you tried to tell me what my scope of practice was. In this state nurse practitioners are independent medical providers. It's up to me to know what my scope of practice is. The details are not spelled out in the law.

Yeah, we went round and you apparently forgot the outcome of that.

Are you claiming providers aren't legally required to report certain infectious diseases? Think that's only about data collection, nothing to do with contact tracing? The report form includes the name and contact information for the patient.

Part of pre-test counseling for HIV testing is informing the person they are obligated to inform sexual partners but if they feel unable to do that, the health department will help them including informing partners without naming the infected person. So you are claiming the provider isn't obligated BY LAW to report that HIV to public health with the expectation public health will do contact tracing and informing?

The Ryan White Act requires a patient's HIV status (when known or discovered) be reported to any EMS provider reporting they've been exposed to the person.

HIPAA also has a "public health clause" that allows contagious disease information to be shared with exposed or potentially exposed persons.

Where do you get the idea physicians are exempt from these important public health laws?

You didn't appear to recognize the ethical dilemma in prescribing placebos.

Your posts reflect one who is very poorly informed about the difference between ethics, medical judgement and law.

Understanding ethical dilemmas involves a lot more thought than a position paper and some 'rules'. Its clear you are never going to admit there are always going to be exceptions to rules of ethics.

A duty to warn is one such exception a fair number of psychiatrists and psychologists have taken the position it overrides the rules you keep repeating. They disagree with you. I disagree with you.

 

[Skeptic Ginger]

I don’t understand what happened with the above post. I only meant to respond to Belz with “Holy ****, man...”

What, the post typed itself?

 

[Cabbage]

Ethics requires following the law.

is now followed by:

Fortunately most medical providers recognize flawed laws and aren't afraid to stand up.

It looks to me like your position on ethics/legality may finally be starting to evolve beyond foolishly naive.

Congratulations on making this big step!

I do have a question. It may be somewhat challenging for you:

Does ethics require following a flawed law?

 

[xjx388]

What, the post typed itself?

Not exactly, I figured it out. I actually started writing a response to a post of yours awhile back. Then I asked myself...”Do I really want to go round and round? No, no I don’t; we simply aren’t going to agree.” I’m using Tapatalk so I guess I saved the draft. When I responded to Belz’s post, I must have restored that draft, didn’t pay attention and hit ‘Reply.”