Presidential Diagnosis

The Goldwater Rule is an ethical guideline adopted by American psychologists and psychiatrists that states that it is unethical for mental health professionals to diagnose or give any professional opinion of a public figure that they have not personally examined and obtained informed consent from to discuss their issues in public. And yet, there is an ongoing parade of professionals disobeying this ethical mandate – diagnosing at a distance, writing articles about his mental disabilities and signing letters about President Donald Trump’s reportedly grave mental health concerns. According to some he has a severe case of Narcissism, a Narcissistic personality disorder. According to others his narcissism is so severe that a personality disorder is insufficient to explain Mr. Trump so instead his problem is that he is suffering from Malignant Narcissism which is dangerous and unyielding.

In talmudic fashion one specialist suggested that the President does not meet the criteria for such a diagnosis because Mr. Trump does not exhibit the emotional stress that someone with such a diagnosis usually has. The counter argument goes that he does not have to suffer anxiety as a result of the disorder, it is sufficient that he causes others to feel the anxiety, and far too many people are made anxious by him.

To my mind, and it is not a diagnosis at all, simply an observation of his behaviors and actions, the President reminds me more of a child with a bad case of Attention Deficit Hyperactivity disorder who has not taken his medication and has not followed his cognitive behavioral therapy recommendations to slow down and focus.. He seems to be unable to complete sentences, tends to ramble, does not answer questions and is easily distracted and highly impulsive. He also is quick to blame others, never admits a mistake and overblows information, in the form of “alternative facts,” to fit an agenda – whether or not his “facts” are documentable.

I think that it is reasonable to assume that most people who aspire to becoming president have a degree of narcissism but that may only be a small part of the issue that defines President Trump.

There have been some who have diagnosed President Obama as having a Narcissistic personality disorder when he was President because he too seemed to be preoccupied with fantasies of success and thinking that he was special. Obama was accused of lacking empathy and was considered by some to be arrogant and haughty. All of these traits, if true, could contribute to a diagnosis. But, as I said, most individuals who aspire to a high office must have some of these traits to succeed in their powerful positions.

Successful leaders can have a dollop of narcissism but they must also be diplomatic in their approach and sensitive to the words they use and the feelings of others. Unfortunately, in public, President Trump seems to lack in these areas. Many are willing to excuse him for these traits attributing them to the fact that he is a business man more than a politician and his temperament is precisely how business is conducted. The argument goes that in order to get things done in business you have to be a bit of a tyrant. I am not sure just how accurate that is as a business model unless it is deemed ok to be a bully by those you do business with, and we all know business men who are determined at their work but never to the point of intimidating others. It is also important to remember that President Trump’s supporters approve of his character and intimidating style. Unfortunately, many are growing very tired of it and unnerved by what is perceived as his arrogance.
The other excuse for Trump’s temperament is that he is just learning how to be a President and that process will take time because he has never held a position as a politician. He is not understood by the press because he speaks his mind far too freely and has not studied the historical precedents necessary to understand long standing US policies. I am also not comfortable with this excuse because a man with the pressures that a President has should spend time on just these issues. In fact, he should spend more time learning how to do the job and less time having rallies.

The criteria for diagnosing ADHD include inattentiveness, impulsivity and an inability to focus. Is this our President? Perhaps. I cannot know because I have not had the opportunity to diagnose him. Still, If it is, there are many highly successful people with an actual diagnosis of ADHD. They have learned how to manage their behavior and temperament. One can only hope that Mr. Trump surprises us all and becomes a highly rated world leader.