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Harvard psychiatrist explains the ‘irritable, pessimistic, angry’ mental disorder that drives Donald Trump to embrace hate

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President Donald Trump continued deriding the Mueller report as a witch hunt this week.

He has both argued that the report fully cleared him of wrongdoing and called it politically motivated and wrong.

Trump also said he would refuse to comply with any subpoenas that might come from other investigations into the administration.

Raw Story spoke Nassir Ghaemi, M.D., M.P.H., a professor of psychiatry at Tufts University in Boston, and lecturer in psychiatry at Harvard Medical School, about Trump’s reaction to the Mueller probe and other investigations of the Trump White House.

He is the author of A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness¸ a New York Times bestseller, about a half dozen other books, and over 200 scientific articles or book chapters.

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The views expressed here are solely his own, and do not reflect those of his employers.

Raw Story: First, the Barr memo seemed to mostly clear Trump of wrongdoing and the President seemed to celebrate it. But then, the full Mueller report showed the president had participated in multiple instances of wrongdoing, even if they didn’t meet the standard of prosecutorial action.

Nassir Ghaemi: The President is furious, deriding the probe as a Witch hunt. Can you explain the President’s reaction?

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I’ve seen Trump as having manic symptoms as part of his personality (what we call “hyperthymic” temperament). I believe Bill Clinton had the same, as did other effective presidents (Franklin Roosevelt, John Kennedy). But there is a “sunny” and a “dark” hyperthymia: The sunny individuals are happier than the average person, and tend to be optimistic, bright, and expansive people.

Clinton was like that; so was Franklin Roosevelt. The “happy warrior” phrase captures this kind of leader.

The dark hyperthymic person is always irritable, pessimistic, angry, and has a half-empty view of the world. Such a person reacts angrily to failure, and unhappily to success. I would say Trump fits that description.

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Raw Story: How do you compare the President’s reaction to past leaders, like when Bill Clinton was impeached?

Nassir Ghaemi: Again, both Clinton and Trump likely had hyperthymic temperaments, but one was sunny and the other dark; hence the differences in their reactions. The sunny hyperthymic is resilient to stress, and “moves on.” The dark type doesn’t.

Raw Story: Where do you see this going?

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Nassir Ghaemi: People with hyperthymia tend to be impulsive, and thus are unpredictable. Hence we can’t predict anything except unpredictability.

Raw Story: What’s the role of mental health experts?

Nassir Ghaemi: Mental health professionals need to avoid two extremes: one is the current standard (the “Goldwater Rule”) of complete silence about public figures. This itself contradicts the ethics of science, which involves the free discussion of competing hypotheses with the confidence that eventually the truth— which is corrected error—will emerge. Science involves refutation of false hypotheses, not censorship of them.

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The other is making politically-motivated statements hidden under the guise of professional expertise.

In between, we need to discuss scientifically sound psychiatric concepts, such as mania and depression, as applied to publicly obvious or proven behaviors or traits. What we know about those scientifically sound psychiatric concepts can provide a context to help understand political leadership, but they provide just a context, with other non-psychiatric factors also being important, not a complete or definitive explanation.

I emphasize that public figures give up some privacy rights if they seek to be elected officials, such as presidents. In a democracy, a leader is elected based on the consent of the governed. The governed cannot consent fully if they are uninformed or if key information about their leaders is hidden from them. This is accepted widely now regarding all medical diseases, except psychiatric conditions, because the Goldwater Rule is stigmatizing and contradicts the claims of wishing parity between medical and psychiatric illnesses. Woodrow Wilson had a stroke in office; it is accepted now that the public had a right to know, instead of the knowledge being hidden, leading to de facto governance by the first lady.

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A solution could begin as follows: All political leaders would be required to give full financial and medical disclosure during their campaigns. They should reveal their taxes in full and submit to an independent medical board, including psychiatrists, which will review their medical records, examine the candidate, and release a full medical and psychiatric report to the voters.

Privacy claims are misplaced. These leaders can order thousands to their deaths. They should make themselves known to those who they wish to command. In a democracy, this is a fair request. Any psychiatric diagnoses obtained should be open to fair-minded, scientifically based discussion by experts on those conditions.

These changes will avoid the pitfalls that led to the Goldwater Rule and will protect American society from leaders who have something to hide. Further, it will allow for psychiatric conditions to come out from the shadows of prejudice, to be appreciated in the light of day for their benefits, and not just their risks. If it fails to drop its current quietist self-censorship, American psychiatry runs the risk of following the lead of Soviet psychiatry. In the USSR, dissidents were hospitalized psychiatrically, diagnosed with schizophrenia (after all, it was delusional to reject communism), and even treated with antipsychotic medications. This approach isn’t likely in a democracy. The errors in America will be of omission.

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American psychiatry stays on the sidelines, while a president criticizes his opponents as “crazy” and “nuts,” fleeing from the professional obligation to fight prejudice against mental illness, even if—especially if—it comes from the president of the United States. American psychiatry stays on the sidelines, while a leader with an authoritarian bent shows empathy to his political base and enmity to those who are different.

Neo-Nazi demonstrations occur and aren’t condemned. Nonwhite nations are ridiculed with profanity, Muslims are denigrated, Hispanic immigrants are vilified. Allegations of sexual infidelity and harassment are ignored or discredited. Some nations and leaders are embraced, and others rejected and isolated, with questionable rationale. The risk of military conflict in some affected regions, like the Middle East, rises. Still, the psychiatric profession—which has much to offer to public discussion about xenophobia, the social psychology of sexism, and the harms of war and violence—remains silent. It needs to speak.


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