Best psychiatrist response I've seen on diagnosing Trump.

[nolabear]

I've been asked a thousand times what I think as a mental health professional. I believe in The Goldwater Rule. This, however, is spot on.

http://www.latimes.com/opinion/op-ed/la-oe-goldenberg-trump-mental-health-20160823-snap-story.html

[TreasonousBastard]

1. Spot on it is...

erhaps the most important reason to skip a psychiatric assessment of Trump is that it just isn't necessary. You don’t have to be a psychiatrist to know that there’s something seriously wrong with the candidate. The lessons I learned in preschool, kindergarten and elementary school — not in medical school, residency and years of psychiatric practice — are what tell me that Trump is unfit for the job. My core values as an American — not my professional training — are what make me concerned about a Trump presidency.

Trump should never be president, but not because he may or may not have a mental disorder. He shouldn't be president because he disparages women, denigrates Mexicans and Muslims and mocks the disabled. He shouldn't be president because he demonizes the media and impugns those who challenge him. He shouldn't be president because he insinuates that his rivals might be assassinated and advocates the commission of war crimes. He shouldn't be president because he rejects science and demonstrates a remarkable lack of knowledge or interest when it comes to foreign and domestic policy.

As a psychiatrist, I don’t have a public opinion on Trump. As a citizen, I certainly do.

[elleng]

2. the so-called Goldwater Rule

— no professional opinions on people we have not personally examined.

The lessons I learned in kindergarten — not in medical school and years of psychiatric practice — are what tell me that Trump is unfit for the job.

[bluedye33139]

3. I love this

I agree, it's very disturbing to me to see people suggest "Oh, if he has narcissistic personality disorder, he should be disqualified from office" or suggesting that if he has a mood disorder he should be "vetted" and barred. People with narcissistic personality disorder make fine and wonderful politicians -- they just have to be smart enough and to have enough self-monitoring to know what they are saying and how it is effecting people around them. Similarly, someone with a mood disorder could perform wonderfully as a politician. Mental health diagnoses should never be used to bar someone from public service.

Ignorance, however, should remain a disqualifier.

[Hortensis]

13. Milder "narcissistic" traits can be very positive,

giving people the confidence to take on big challenges.

But personality disorders are called disorders for a reason. They are chronic -- they're NOT going away, though they may become more or less over time.

They interfere seriously with a person's ability to function in society and can even interfere with cognitive function and judgement, the crux of the problem with Trump.

They are typically very hard if not effectively impossible to treat sufficiently. There is no pill to turn a woman who literally cannot turn on her own lights for herself, who weeps and wrings her hands at the very thought of taking such responsibility, into a confident functional person.

[3catwoman3]

4. I don't think the current...

...DSM has a diagnosis of "mean-spirited, bigoted, self-centered jackass," so I will continue to refer to him as such.

[VOX]

5. "You don’t have to be a psychiatrist to know that there’s something seriously wrong..."

"...with the candidate."

Perfectly stated.

[TheBlackAdder]

6. The Goldwater Rule might apply to a common person, but someone with decades of historical data...

.


There comes a point where one does not need to be placed on a couch to reach a DSM-V diagnosis.


Trump has decades of consistant and recorded interactions which paint predictable behavioral characteristics.


.

[TexasBushwhacker]

7. I think they can conclude something is wrong but not necessarily what

Narcissistic Personality Disorder?
Sociopath?
Bipolar manic?
All of the above?

[TheBlackAdder]

9. I lean towards Borderline Personality Disorder, with stronger sociopathic and NPD traits.

.


But, this is a layperson's impression. He doesn't seem to have extreme fits of mania and depression, so I would discount bipolar disorder. He does seem to have multiple traits, all a component of BPD.


The exact, definition by Hoyle, meaning isn't really that important. Since five psychologists or psychiatrists could come up with slightly different conclusions with the same set of interviews. Suffice it to say, he's got some serious issues that are probably part genetic and family induced. His parents must have been real winners.


.

[TexasBushwhacker]

10. And his brother Fred drank himself to death

Donald was becoming a little thug and got shipped off to military school when he was 13. Me thinks the Trump household wasn't a warm and loving place.

[TheBlackAdder]

12. It seems to be just as sweet as the dystopic Koch household.

[Hortensis]

14. Agree. The Goldwater Rule is obsolete as written and

invoking it absolutely in this situation is highly irresponsible.

Certainly very strict rules should apply to professionals in this respect. That's not in question.

Amateurs shouldn't make their own diagnoses and throw them around irresponsibly. That is not in question either.

However, in a circumstance where a dangerously unsuited candidate is one election away from the oval office, it is shockingly irresponsible for any professional organization to sit virtuously on its hands instead of amending its rules to allow carefully limited statements of evaluation.

Today's reality is, although Trump might behave differently in private than public, over 40 years of records of his behaviors are available on paper, including numerous court records, on film and tape, and his own statements on social media, in addition to the well over 1000 hours of video available to anyone with a computer.

This is very, very different from when Goldwater was a candidate and would be more than sufficient for, for instance, a group of practitioners chosen to speak on behalf of a respected professional organization to issue a knowledgeable and responsible statement of provisional diagnosis.

Professionals also know a great deal more about mental disorders and the workings of the brain than in the 1960s.

If mental health professionals won't speak up to prevent us from electing someone they all personally believe suffers from a debilitating and potentially literally disastrous mental disorder, who will?

I completely reject any facile attempt to shift this responsibility to everyone who has graduated from kindergarten to first grade. In an extreme situation like this, it absolutely is the responsibility of leaders in the mental health profession to provide the electorate with their professional opinion.

[LAS14]

8. k & r

[renate]

11. for those who are registered users of Medscape, this is interesting

(I don't think the article is accessible except by registered users)

The author points out that in some situations, psychiatrists may have a duty as citizens to discuss psychiatric diagnoses.

http://www.medscape.com/viewarticle/867320_3

Before Hitler came to power, a prominent psychiatrist in Germany, Karl Wilmanns, diagnosed him as having hysteria during World War I, when he was treated in a psychiatric hospital. At the time, hysteria was a relatively new concept, but later research has supported Wilmanns' observation, with documentation that Hitler was "personally examined" and diagnosed with hysteria by a psychiatrist, Edmund Forster. Forster committed suicide a few days after Hitler came to power in 1933; Wilmanns was fired from his university professorship and never allowed to work again.

In a little known anecdote, around 1940, some German generals who were plotting a coup against Hitler tried to solicit the support of prominent psychiatrists, including the academic professor Dr Karl Bonhoeffer, father of the prominent anti-Nazi activist Dietrich Bonhoeffer. The generals knew that Hitler was mentally unwell, and they wanted the psychiatrists to agree to hospitalize Hitler involuntarily. It is unclear how the process unfolded, but the plan never went into effect.

Would it have broken the Goldwater rule if Dr Karl Bonhoeffer had worked with the generals to hospitalize Hitler against his will? Did Hitler in fact have a psychiatric diagnosis? I have provided evidence that he did, namely manic-depressive illness, which was worsened with daily intravenous amphetamine treatment for his depression.

Even if one thinks that there are psychological limitations to the presidential fitness of Donald Trump, as some do, we are certainly not in the same situation as with Hitler. But the question does come up: When is it acceptable, even necessary, for psychiatrists to be citizens first?