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Friday, April 12, 2024

In 2016 I was criticized for diagnosing Trump as dangerous


The occasional Trumpology series of columns are informed by my 40 years of experience as a clinical social worker and psychotherapist (not a psychiatrist like Lucy in the drawing) and my understanding of psychiatric diagnosis, psychology, and psychopathology as applied to Donald Trump who I consider to be a sadistic impulsive malignant narcissist.

Non-therapists throw around words like nuts and unhinged to describe Donald Trump. Therapists like me get can, if they choose to do so, get more technical. Whether one has the clinical training and acumen to make a diagnosis based on far more information than a psychotherapists could ever get in a face-to-face assessment of a patient, or one just has common sense unsullied by bias and gullibility doesn’t really matter. Trump’s behavior demonstrates that he is too impulsive, unstable, and irrational to be president.

I have had referrals to conduct fitness for return to duty evaluations for police officers who went through traumatic incidents, but I am not an expert. Psychiatrist Steven Buser is an expert on this kind of assessment. He works for the United States Air Force where one of his responsibilities is evaluating the mental stability of airmen who handle nuclear weapons, using the standards laid out in what is called the Nuclear Personnel Reliability Program which has the following criteria:

Only those personnel who have demonstrated the highest degree of individual reliability for allegiance, trustworthiness, conduct, behavior, and responsibility shall be allowed to perform duties associated with nuclear weapons, and they shall be continuously evaluated for adherence to PRP standards. The PRP evaluates many aspects of the individual’s work life and home life. Any disruption of these, or severe deviation from an established norm would be cause to deny access. The denial might be temporary or permanent.

In a Jan. 17, 2018 New York Times OpEd Would the Air Force Let Airman Trump Near a Nuclear Weapon?” (readable without subscription) he wrote:

I have not had the opportunity to examine the president personally, but warning signs abound. What if I had reliable outside information that Airman Trump displayed erratic emotions? That I saw very clearly that he was engaging in cyberbullying on Twitter? That he had repeatedly made untruthful or highly distorted statements? That his language implied he engaged in sexually abusive behavior? That he appeared paranoid about being surveilled or persecuted by others, that he frequently disregarded or violated the rights of others?

In the process of searching for new references to Trump’s mental instability I came across an old reference to myself which I forgot about in the website Ethics Alarm which is published by Jack Marshall. He is an ethicist, which he notes means he makes his living teaching, consulting, speaking and writing about ethics. He is a lawyer, and the president of ProEthics, Ltd. (Reference)

His Aug. 9, 2016 article “Is the Goldwater Rule necessary”  was published a few days after I posted “The Never-ending Controversy About Diagnosing Donald Trump” on Daily Kos.

He writes:

Trump is  a narcissist. I’m no psychiatric professional, but diagnosing Trump as a narcissist takes no more expertise than diagnosing a guy who dresses as Scarlet O’Hara and talks to himself while he wanders through Times Square with a dead goose strapped to his head as “nuts.” Hal Brown argues at the Daily Kos that reviewing the symptoms of narcissistic personality disorder (NPD) , applying them to Trump and suggesting that having certain of them to the level he does  precludes him from being fit to be president isn’t unethical at all. Brown, who is a clinician, cites two typical descriptions of the disorder…

In taking a new look at what Marshall wrote I want to add emphasis to a few words which he decided to quote: “reviewing the symptoms of narcissistic personality disorder (NPD) , applying them to Trump and suggesting that having certain of them to the level he does  precludes him from being fit to be president….”

Since writing the article in Daily Kos I have revised my diagnostic assessment of Donald Trump  because he meets every criteria for being a malignant narcissist.


Wikipedia explains that “a notable difference between “narcissists” and “malignant narcissists” is the “feature of sadism, or the gratuitous enjoyment of the pain of others. A narcissist will deliberately damage other people in pursuit of their own selfish desires, but may regret and will in some circumstances show remorse for doing so, while a malignant narcissist will harm others and enjoy doing so, showing little empathy or regret for the damage they have caused.”

Malignant is one of the most frightening words many of us have ever heard. It usually refers to cancer which has spread and may be life-threatening.  When the preface malignant is applied to the word narcissism it describes Donald Trump.

That is besides the point. Whether he was a police officer being evaluated as to whether he was ready to get his badge and gun back, or an Air Force officer responsible to launching nuclear weapons, Trump is not currently fit to be president. A responsible clinician would require him to undergo psychotherapy before being given a clean bill of health to get his nuclear button back.


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