Donald Trump is not mentally ill, according to the man who created the manual on how to diagnose mental illness.
Dr Allen Frances was chair of the Department of Psychiatry and Behavioral Sciences at Duke University when he oversaw the task force to build today’s psychiatry manual.
He has been scathing about the president, branding him a narcissist and ruthless self-promoter.
However, he dismisses the scores of ‘armchair diagnoses’ from health professionals who claim Trump must be mentally ill.
According to Dr Frances, the 72-year-old does not fit the criteria for narcissistic personality disorder, delusional disorder, and dementia – the illnesses most commonly ascribed to him.
Writing for medical site STAT News, Dr Frances explains, in his view, why the president does not qualify.
Dr Allen Frances was chair of the Department of Psychiatry and Behavioral Sciences at Duke University when he oversaw the task force to build today’s psychiatry manual. He insists Trump does not have narcissistic personality disorder, delusional disorder or dementia
He warns that making flippant diagnoses merely stigmatizes other people with mental illness, and suggests no one with a mental illness could hold such a high position.
‘Confusing Trump’s behavior with mental illness unfairly stigmatizes those who are truly mentally ill, underestimates his considerable cunning, and misdirects our efforts at future harm reduction,’ he writes.
‘Buried in the noisy debate about Trump’s mental health is the misinformed and noxious assumption that mental illness somehow automatically disqualifies someone for high leadership position.’
In fact, he believes invoking the 25th Amendment – removing the president due to sickness – would cause more problems for the state of the country.
‘Assigning psychological disorders to Trump is not only wrong but futile,’ he says.
‘Any psychological fitness exam would also be inherently biased and unreliable.
‘He may not be crazy, but we certainly were for electing him.’
Here, Dr Frances breaks down each illness to show how the president does not fit the bill:
NARCISSISTIC PERSONALITY DISORDER
What is it?
These are the symptoms defined in the DSM manual:
- Having an exaggerated sense of self-importance
- Expecting to be recognized as superior even without achievements that warrant it
- Exaggerating your achievements and talents
- Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believing that you are superior and can only be understood by or associate with equally special people
- Requiring constant admiration
- Having a sense of entitlement
- Expecting special favors and unquestioning compliance with your expectations
- Taking advantage of others to get what you want
- Having an inability or unwillingness to recognize the needs and feelings of others
- Being envious of others and believing others envy you
- Behaving in an arrogant or haughty manner
Does Trump qualify?
Dr Frances concedes that Trump ‘is an undisputed poster boy for narcissism’ and ‘demonstrates in pure form every single symptom’.
However, he told STAT, the president falls short on one point: ‘To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment.
‘Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way.’
DELUSIONAL DISORDER
What is it?
These are the symptoms defined in the DSM manual:
- Presence of one or more delusions with a duration of one month or longer.
- The criteria for schizophrenia has never been met. Note: Hallucinations, if present are not prominent and are related to the delusional theme (e.g., the sensation of being infected with insects is associated with the delusions of infestation).
- Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
- If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
- The disturbance is not better explained by another mental disorder such as obsessive-compulsive disorder, and is not attributable to the physiological effects of a substance or medication or another medical condition.
Does Trump qualify?
Dr Frances explains that Trump is branded ‘delusional’ because he believes conspiracy theories, such as claiming Obama was not born in the US.
However, he told STAT Trump is hardly unique in this – and that is the thing that shows he is not clinically delusional.
‘Conspiracy theorists are a dime a dozen, while those with delusions are more rare,’ he says.
‘Up to half of all Americans believe in strange conspiracy theories. They are wrong, but not delusional.’
DEMENTIA
What is it?
The DSM manual says patients much show a clear decline in these areas:
- Learning and memory
- Language
- Executive function
- Complex attention
- Perceptual-motor
- Social cognition
Does Trump qualify?
Many say Trump’s simplistic speech patterns and constant repetition show he has issues with his brain.
Dr Frances claims we can see the same kind of repetition in Abraham Lincoln’s speeches, but the repetition is masked by the eloquent sentence structure.
He says the fact that Trump is less eloquent does not mean he has dementia.
He adds: ‘Convincing proof that Trump is not demented is his undiminished creative and canny skills at blaming, bare-knuckle political fighting, and self serving.’