A Brave Psychiatric Professional Diagnoses the Mental Condition of President Trump

It’s easy for non-professionals, journalists and anyone with eyes and ears to label President Trump as a narcissist and pathological liar, but what do mental health professionals have to say about him?

A reader sent me a fascinating 32-page academic paper by Vincent Greenwood, PhD, executive director of the Washington Center for Cognitive Therapy, with the catchy subtitle, “The Substance Behind the Assertion the President Has a Serious Psychiatric Condition.”  Click here to view the full 32-page document, or click here to read a shorter 12-page version of it. It’s worth checking out, whether or not you’re a supporter of President Trump.

The full-length paper is so long because it’s incumbent upon the author to justify his attempt to diagnose someone without a personal interview. Normally, that would be hard to justify, and would be considered a violation of Sec. 7.3 of the American Psychiatric Association’s code of ethics, which states that it is unethical to offer a professional opinion on a public figure who has not been personally examined and where consent has not been obtained.

Dr. Greenwood, however, cites a 2017 paper which argues that a diagnosis is possible and reasonable when there is substantial information available from the subject himself, from informants and from archival data such as “speeches, tweets, taped interviews, autobiographical efforts, court records, real-time observations, etc.,” which is certainly the case with President Trump. Although Dr. Greenwood doesn’t say it directly, one could surmise that the APA opposes diagnosis of public figures at a distance because of the damage it could do to the reputation of the mental health profession.

In his paper, Dr. Greenwood describes at length the instrument he used to diagnose the president, something called the Hare Psychopathy Checklist Revised, which he describes as a “reliable instrument that yields a valid diagnosis, but also spells out a rigorous process for how to go about making a possible diagnosis. This process involves the collection, integration, and interpretation of multiple sources and types of information. The process is comprehensive and detailed and strives to go well beyond just citing examples of Trump’s more outlandish behavior as definitive proof of a psychiatric disorder.”

So how does President Trump score on the 20-point checklist for psychopathy?  I don’t have the space here to relate Dr. Greenwood’s thorough documentation of each of the 20 items on the checklist. I encourage you to click on the link above for either the 12- or 32-page paper and see how persuasive his reasoning is. Suffice it to say that Dr. Greenwood concludes that the President “is a clinical psychopath (in the moderate to severe range).”

Personally, I was shocked at the severity of the diagnosis, although convinced by Dr. Greenwood’s analysis. Previously I had been convinced of an alternative diagnosis, that of Narcissistic Personality Disorder (NPD). On page 26, Dr. Greenwood describes “the low-hanging fruit of narcissism,” noting that many of the nine criteria of NPD “seem to be written almost with the President in mind” and that only 5 of the 9 criteria are needed to warrant the diagnosis. However, Dr. Greenwood writes, “To highlight Trump’s narcissism is misleading because the psychopathic elements of his personality are more central to who he is and how he operates.”

Another and related must-read is A Warning, liked by 83% of Google users.  It is described by Wikipedia as “a 2019 book-length exposé of the Trump administration, anonymously authored by someone described as a ‘senior Trump administration official.’  It is a follow-up to an anonymous op-ed published by the New York Times in September 2018.” It provides countless additional “datapoints” to support Dr. Greenwood’s diagnosis, and is reinforced by what former National Security Advisor John Bolton has written in his best-selling book, The Room Where It Happened.  It is liked by 80% of Google users.

Trump’s Worst Legacy May Be Modeling His Communication Style to His Followers

Actually, President Trump will have many “worst legacies,” but the one that’s most present for me at this time is how he has emboldened ordinary people to think it’s okay to communicate like him. That’s what presidents do, after all. They become role models for Americans who look up to them.

Let’s look at the role model being demonstrated day in and day out by our current president.

I received a hand-written letter just this week from a reader, who wrote as follows:

Dear Mr. Smith,

I enjoy your column and wanted to say my piece.

Being 89½ years old and a retired R.N., I’ve seen much in my lifetime but nothing like Mr. T. His Narcissistic Personality Disorder disturbs me most. Each time he speaks, all the symptoms come forth: Profound arrogance, hypercritical, public ridicule, no sympathy, a bully.

It is a mental illness and is untreatable. Were he my child, he would have been put in time-out long ago. As you said, his supporters are unreachable and that is baffling. Look forward to reading your thoughts. 

Sincerely, Mrs. Vivian S.

Yes, Vivian, one wonders whether his supporters would tolerate those same “symptoms” in anyone else. Who among them would like a person displaying “profound arrogance," being hypercritical, using public ridicule, evidencing no sympathy, and being a bully?  I doubt any of his supporters like those traits in another human being — any human being — but they accept them in Donald Trump. Worse, they are adopting those traits for themselves.

    Unless your circle of friends includes Trump supporters, you may not witness those behaviors much, but, thanks to this column, I receive emails every day from them, evidencing such language.

    Here’s a recent email from Steve M.:

    “You are a lousy journalist.  You cant even spell my name correctly.  No wonder you cant earn a living doing journalism. So you resort to petty name calling and a completely lame attempt to sell real estate.  You or your parents wasted a lot of money at MIT.” (The writer went on at length -- too long to share here.)

Trump supporters, while they admit he’s crude and rude (“but gets things done!”), they deny those symptoms.  One, however, admitted the narcissism this way:

The potus is a narcissist?  Not really startling news! Btw, bho’s picture is featured in the DSM-5 manual in the section defining a narcissistic personality? Trump simply took a page from bho’s book? Why doesn’t bho’s narcissism bother you?

(“bho” is Obama, referred to by another Trump supporter in emails only as “B. Hussein O.”) 

The president also is a role model for lying — even when it’s not necessary. While he said, metaphorically, that he could shoot someone in the middle of Fifth Avenue and not lose any supporters, it’s just as likely that he could say the earth was flat (okay, metaphorically) and his supporters would accept it as the truth — and Fox News would promote it! 

It’s one thing that supporters don’t think Trump lies, despite repeated evidence of it, but, worse, he’s made bending the truth acceptable by modeling it.

Parents of bullies and the bullied alike have decried bullying in our schools, yet millions of American have learned from “Mr. T.” that bullying is acceptable in adults. This is nothing less than hypocrisy, unless they now accept bullying among school children.

The same for ridicule. Who thinks that ridiculing others is acceptable discourse? Again, it’s being normalized by this president in virtually every tweet. I expect to receive emails ridiculing Vivian S. for her letter above. That’s what they've been taught — by example.

Would Trump's supporters like anyone other than Trump criticizing and ridiculing a newly deceased war hero, as Trump did Sen. John McCain because he opposed Trump politically?

Maybe the tide will turn, now that we are seeing the generals speaking up. And what will we learn from Steve Bannon’s book, due this month or next?

Speaking of books, I’m currently reading A Warning by “Anonymous, A Senior Trump Administration Official,” available for as little as $3.99 on eBay with free shipping. It’s an insightful and scary look inside the Trump White House.  I consider it a must-read!