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Trump and NPD

Dear editor:

According to some polls, many Trump supporters are concerned about his personality, even while supporting him otherwise. Like many Americans, across party affiliations, I, too, am worried about Trump's mental health.

In my case, at the beginning of his campaign during the primaries, I saw that he almost certainly had Narcissistic Personality Disorder (NPD). Trump presents a classic textbook case. His symptoms were fully displayed on television, providing more samples of his behavior than a mental health professional would usually have access to in order to accurately diagnose him. Some years ago, I worked in mental health (for about 10 years, though not recently) and have both an M.S. and Ph.D. in psychology. People with this problem change with great difficulty, if at all, and tend to learn little from their interpersonal experiences. Individuals with this diagnosis are least likely to admit that anything is wrong. They react negatively to criticism while having poorly developed empathy. They are grandiose, manipulative and denigrate or put down others and create divisiveness in the social groups of which they are a member.

During the presidential campaign in 2016, 27 psychiatrists published a joint letter asserting that Trump had a "malignant" narcissistic personality disorder, meaning a person who engages in harmful and vengeful actions as a feature of his Narcissistic Personality Disorder (NPD). They did this although making public statements diagnosing a public figure has been proscribed as unethical by the American Psychology Association (APA) since Barry Goldwater's campaign. Predictably, they were subsequently criticized for it by the APA. This ethical principle was formulated after Goldwater's mental health was questioned surrounding his possible willingness to engage in a nuclear war. Thus the "Goldwater Rule" was formulated, which condemns publicizing diagnoses without having examined a person. At the present time, this information would almost certainly violate HIPPA, as well, if in fact a clinician should formally diagnose him.

These 27 psychiatrists spoke out, based on the "Duty to Warn." This is the requirement to break confidentiality if persons could be seriously harmed by the projected actions of an individual.

It makes sense to be concerned about a leader with narcissistic traits. World War II, arguably started by narcissistic dictators (Hitler and Mussolini) resulted in an estimated 70-85 million death toll. Having a malignant narcissistic leader can be more deadly than a pandemic.

Trump has the characteristic grandiosity, lack of compassion or empathy, self-centered focus, a need for excessive admiration, a sense of entitlement, and interpersonally exploitive behavior, including denigration of others. The DSM-5 is the reference for psychiatric diagnoses. A fewer number of clinicians think that he might have anti-social (or sociopathic or psychopathic) personality disorder, which has some of the same symptoms as NPD; i.e., lying, manipulation and self-centeredness. Yet, another opinion is that he could have another character disorder, i.e., sociopathic or psychopathic, disorder.

There are grounds for serious concern about his personal stability when you consider that he is the leader of the Free World. I am personally concerned.

Valerie Jones Gonzalez, M.S., Ph.D.

Hot Springs

Editorial on 03/19/2019

Print Headline: Tuesday's Letter to the Editor

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