Psychiatric professionals are at odds about a decades-old regulation in their profession that forbids them from speaking out about the mental health of public officials.
Scientific American reported Wednesday on a letter to the New York Times signed by 35 U.S. psychiatrists, psychologists and social workers who are flouting that regulation to speak out about Pres. Donald Trump, who they -- along with some of the president's colleagues in the Senate -- believe is dangerously unwell.
Meanwhile, the psychiatrist who wrote the diagnostic criteria for narcissistic personality disorder wrote a letter of his own to the Times urging his colleagues not to mistake Trump's "grandiosity, self-absorption and lack of empathy" for mental illness.
"Bad behavior is rarely a sign of mental illness," Professor Allen Frances cautioned, "and the mentally ill behave badly only rarely."
In their letter, the 35 psychiatric professionals said, "Mr. Trump’s speech and actions demonstrate an inability to tolerate views different from his own, leading to rage reactions. His words and behavior suggest a profound inability to empathize. Individuals with these traits distort reality to suit their psychological state, attacking facts and those who convey them (journalists, scientists)."
They continued, "In a powerful leader, these attacks are likely to increase, as his personal myth of greatness appears to be confirmed. We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president."
Frances countered, "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."
He is no Trump booster, however, saying, "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)."
Attempting to diagnose Trump from afar, Frances said, is "misguided." Yes, he must be spoken out against, the psychiatrist wrote, "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," he concluded.