What is Inside the Mind of Donald J. Trump: His Thinking and Action Model

Looking, wondering and questioning: We may never know

(Maybe in the end, a new reality show or a shrewd act)

A very timely subject for sure: What makes Donald J. Trump tick?

Until now, people who could have shed light on any president’s mental state were professionally hindered from doing so by the so-called Goldwater Rule — named for the late Sen. Barry Goldwater (R-AZ) – whom some psychiatrists took to calling crazy because of his foreign policy views (about use of nukes).

That rule admonishes medical professionals not to opine on the mental health of people whom they had not examined. In the context of Donald J. Trump, however, there is some buzz  about doing away with the rule on the grounds that psychiatrists should be able to give their best medical judgment to “warn the public.

Case in point: Lance Dodes, a retired assistant clinical professor of psychiatry at Harvard Medical School, believes that, in this instance, the Goldwater rule is outweighed by another ethical commitment: A sworn “duty to warn” others when they assess that a person might harm them.  Like many of his colleagues, Professor Dodes speculates that Trump fits the classic medical description of someone with:

“… malignant narcissism, which is characterized by grandiosity, a need for admiration, sadism, and a tendency toward unrealistic fantasies.”

On February 13, 2017, in the letter liked above, Prof. Dodes and 33 other mental-health professionals wrote, in part: “We fear that too much is at stake to be silent any longer.”

In response to that letter, Allen Frances, a professor emeritus at Duke University Medical College, who wrote the section on narcissistic personality disorder in the “Diagnostic and Statistical Manual of Mental Disorders — IV,” sought to discourage the public diagnoses. Frances wrote in part: “Trump 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. The antidote to a dystopic Trumpean dark age is political, not psychological.”

As the letter to the New York Times illustrates, mental health professionals can challenge or defy the Goldwater Rule. It’s up to medical associations to enforce professional ethics. We are going to hear a lot more from such people, I suspect, as Trump displays his temperament in high-pressure situations.

Recall that there was myriad of problems with diagnoses by doctors not treating a patient and a lot of unfounded speculation about Hillary Clinton’s health got out of hand (mostly from the Trump camp and pool of Trump supporters and critics, not to mention some psychiatrists.

In any event, it is not clear that a finding that “the president is suffering from a narcissistic personality disorder” can be used to invoke the 25th Amendment.

There are, however, a few points on which many Americans can agree.

First, there is a fundamental difference between calling someone “crazy” because of his views, for example, on the Vietnam War and questioning someone’s mental stability based on his behavior, speech and other observable factors.

Second, Congress could try to pass a law requiring an annual physical and mental checkup for the commander in chief, although it would have to get past a likely veto. Congress would also need to figure out how to enforce such a requirement and tackle the issue of doctor-patient confidentiality. All of that seems a bit much to overcome.

Third, in an era when anyone has access to social media, we are going to see professional and unprofessional voices eager to assess a president whose behavior seems out of the ordinary.

Then this from Trump re: inviting the PI President to the White House – that and Trump’s previous praise for Putin and his warming up honor to a meeting with  North Korea’s Kim, Jung-un (Trump even called him a “Smart cookie”) – well,  that seems to show his newly formed circle of “friends” – that is: dictators and strong armed men. What does that deep seated view mean anyway, I have to wonder? Keep in mind that we still have over 1,200 days with this man in office, so, hang on tight to anything you can.

Before I leave, you might enjoy this June 2016 article from The Atlantic reflecting back to 2006 and even further into Trump’s life – worth reading.

The author’s bio of that piece is here.

Thanks for stopping by.