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Sunday, February 26, 2017


Having ambitions is no substitute for being a person.


jimf said...

> Having ambitions is no substitute for being a person.

Only if you're a Loser (TM). ;->

Speaking of which -- remember the debate we had a few months before
the election about the alleged pathological personality traits of
Candidate Donald, and whether such discussion was legitimate, or
ethical, or useful, or fit for public consumption?

( )

The beat goes on, apparently (in spite of the warning back then from
the president of the American Psychiatric Association), though it's surely
less useful **now** than it might have been before the election.
"Duty to warn" on MSNBC's Lawrence O'Donnell Show
Published on Feb 22, 2017
Mental health professionals discuss duty to warn public about
Donald Trump's mental illness

John Gartner (a therapist in private practice; I gather he's
a psychologist and not a psychiatrist, because he isn't an MD)
says in the MSNBC interview (after calling Trump a "paranoid psychopathic
narcissist, divorced from reality"):
You know, this Goldwater Rule is frankly absurd, from three different
vantage points. First, the debacle that took place during Goldwater's
era was in the Freudian time, before we had the Diagnostic and Statistical
Manual. The great advance of the [DSM] is it gave us clear behavioral
diagnostic criteria for every disorder. So whereas these psychiatrists
[back in 1964] were saying he [Goldwater] had potty-training issues and
latent homosexuality issues that were unproved concepts, we now know, if
we can observe someone's behavior and their words, we know that we can
diagnose them. And actually this whole idea that the psychiatric interview
is the gold standard for making an assessment is just frankly not true.
Empirical research shows that the psychiatric interview is one of the
least reliable ways of forming a diagnosis, that behavior and informants --
and obviously we have thousands of hours of behavior and informants --
are much more accurate. And finally, as far as ethics go, I would argue
to my colleagues that those who **don't** speak out are being unethical.
That if we have some knowledge and understanding about the unique danger
that Donald Trump presents through our psychiatric training and we **don't**
say something about it, history is not going to judge us kindly.

jimf said...

However, one of Gartner's professional colleagues has disagreed with him in the
New York Times.

From the Forbes article:
The fellow who drafted the N[arcissistic]P[ersonality]D[isorder] criteria
[in the new DSM V], Allen Frances, a professor emeritus at Duke University,
has very publicly disagreed with the idea that Donald Trump has NPD. . .

Frances sent a response, also published in the New York Times,
one that reflects comments he has already made on Twitter, where he said:

> I wrote DSM criteria for Narcissistic Personality Disorder.
> Trump doesn't meet them. He's terrible person & classic schmuck-
> not mentally ill.

I reached out to Frances for comment but received no reply. However,
in the New York Times, Frances noted that “bad behavior is rarely a sign of
mental illness” and said:

> . . .[H]e does not suffer from the
> distress and impairment required to diagnose mental disorder.
> 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).

In an email to me, Gartner offered a riposte regarding what Frances had to say about distress:

> There is rumor he is unhappy in the job. He seems constantly enraged at the
> imaginary evil enemies, lying about him, attacking him, impeding him and
> committing outrages against him (like rigging his election, even though he won).
> He doesn't seem like a happy person does he? . . .

These back-and-forths may seem like parsing of finer points among professionals
while Rome is burning, but the ethics questions matter. . .

Why Em Em Vee?