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Like a billowing medical book for a chronically ailing ICU patient, every anniversary sees new additions to the folders of affirmation for Donald Trump’s afflicted apperception and his brainy affliction for the presidency. This accomplished week, in the “History of Present Illness” section, it was his abridgement of affinity and accusation alive for the abhorrent acknowledgment to hurricane-ravaged Puerto Rico. For “Past Medical History,” it was the unearthed recording of a chat with trashmaster Howard Stern, wherein Trump appallingly declared his carelessness and abhorrence appear an aged man bleeding on Mar-A-Lago’s floor. (Just as alarming is Trump’s blindness that his acknowledgment should be account for shame.)
So, what absolutely is psychologically amiss with this man, and what makes him alarmingly unfit for attainable office? In this time of Trump-induced peril, is it still ethical for the American Psychiatric Association (APA) to gag its members’ accent adjoin the president, beneath their Goldwater Aphorism of 1973? And added broadly, what are the cerebral furnishings of a Trump presidency, and what does Trump’s acceleration to ability say about this country?
For answers to these questions, there is no bigger abode to about-face than The Alarming Case of Donald Trump: 27 Psychiatrists and Brainy Bloom Experts Appraise a President. Edited and brought calm by Bandy Lee, the analyst who organized Yale’s “Duty to Warn” appointment beforehand this year, the responses independent in this book’s 360 pages are detailed, insight-rich, and well-reasoned.
Lee has accumulated a dugout abounding of ability hitters for this volume, with experts advancing from admired institutions such as Harvard, Hopkins, NYU, UNC-Chapel Hill, and UCSF. Amid the accidental psychiatrists, psychologists, and psychotherapists are leaders in the acreage like Judith Herman, the analyst columnist of a seminal assignment on PTSD, Agony and Recovery; Philip Zimbardo, the analyst who conducted the Stanford bastille experiment; and Robert Lifton, the analyst acclaimed for his studies of Nazi doctors and Hiroshima survivors. (If alone Trump’s chiffonier independent such beaming talent, we could feel abundant safer.)
A absolute and affected prologue by Lee and Herman lays the arena rules for the three sections that follow. In it, the authors accept the impossibility of giving Trump a absolute assay in the absence of analytic interviews and testing. They additionally apriorism that the APA’s Goldwater Aphorism should alone be burst in the accident of an emergency, and this is one such time. Lest there be any doubt, they achieve with the 27 authors’ accepted aplomb that “anyone as mentally ambiguous as Mr. Trump artlessly should not be entrusted with the life-and-death admiral of the presidency.”
Part One (The Trump Phenomenon) focuses aloft the affection and behaviors that cede the admiral imminently dangerous. The assorted authors in this area altercate that Trump exhibits impairments constant with assorted diagnoses, including Egotistic Personality Disorder, Alienated Personality Disorder (or sociopathy), paranoia, hypomania, and possibly dementia.
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The clinicians do an accomplished job, accumulating a greatest hits accumulating and several B-sides of Trump’s deranged statements and abhorrent behaviors to accomplish their cases. Their assessments amount the president’s absolute lifetime, admitting with accent primarily aloft his words and accomplishments while advancement and now as president. Their accretion is a appalling expedition bottomward Memory Lane and absolutely anathema in its totality.
The alone affiliate that I begin unpersuasive was analyst Michael Tansey’s altercation of Delusional Disorder, a attenuate action by allegory to those already mentioned. To use a age-old analytic aphorism, back you apprehend ankle beats alfresco your window, it’s usually a horse and not a zebra.
Far added acute is analyst John Gartner’s overview of cancerous narcissism, which appears to tidily abbreviate the Man in the Red Cap. A analytic assemble originally developed by the affecting psychoanalysts Erich Fromm and Otto Kernberg (both refugees of Nazi Germany), cancerous narcissism is comprised of four capital components: Egotistic Personality Disorder, alienated behavior, batty traits, and sadism.
Before I move forth and altercate Allotment Two, I’ll go advanced and acknowledge to what I ahead will be a primary criticism of The Alarming Case of Donald Trump. I apprehend that abounding reviewers and readers will altercate that the complication of attainable diagnoses presented actuality weakens the case for Trump’s brainy impairment.
To acknowledgment this, I’ll comedy my “psychiatrist with over 20 years of analytic experience” card, and action a four-fold reply. First, aloof as generally as not, patients accommodated the belief for added than one diagnosis. Second, our capital apparatus for assay in psychiatry – the Analytic and Statistical Manual of Brainy Disorders, Fifth Edition (DSM-5) – is far from perfect, an ever reductionist admission to the assortment and acquiescence of animal behavior. But as a above Secretary of Defense already said, we go to war with the army we have, not the army we ambition we had.
Next, our admiral has not submitted to interviewing and testing, lending the altercation an assured imprecision. Therefore, it’s added authentic to accede the disorders explicated in the book as allotment of a cogwheel diagnosis, rather than annihilation conclusive. And lastly, able altercation over exact diagnoses is the barometer in our specialty, accustomed (in best cases) the abridgement of claret tests and neuroimaging studies to accouter the greater authoritativeness that comes with, say, diagnosing diabetes or a specific blazon of cancer.
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In accession (and here’s a nice segue to Allotment Two), one of the amount theses of Parts One and Two is that absolute diagnoses are not the key to able affair about Trump. Instead, the foremost anguish is dissection dangerousness, because addition so acutely paranoid, impulsive, and advancing should not accept sole admission to the nuclear codes.
Part Two (The Trump Dilemma) mostly revolves about the belief of the Goldwater Aphorism vis-à-vis our added obligations as brainy bloom professionals. I begin this area to be argued flawlessly.
Highlights accommodate a acicular ethical assay by Leonard Glass (a Distinguished Life Fellow of the APA, until he accommodated in beef beforehand this year) demonstrating that in its accepted awry execution, Emperor Goldwater has no clothes. Glass writes that the Goldwater Aphorism bespeaks the APA’s “profound abridgement of account for and aplomb in the ability and acumen of its members.” He gain to say that the aphorism is acutely attenuated in its abortion to analyze amid a arcane analytic appraisal of a accommodating and a able assessment offered in the attainable square. Ironically, too, the Goldwater Aphorism runs countercurrent to one of the APA’s amount missions (reiterated in a 2013 publication) to brainwash the public.
In his chapter, Harvard analyst Henry Friedman compellingly claims that the APA’s cogent its associates to about-face off their admiral of ascertainment plays anon into the Trumpian address of acceleration and tripling bottomward on his lies until the adviser doubts their own analytical faculties. Fellow analyst James Gilligan builds aloft Friedman’s accusation of the APA, anecdotic it as Trump’s “passive enabler.”
In one of abounding apt Nazi Germany analogies begin throughout this book, Gilligan utters what may be the adumbration of the year: “It does not assume to me that the German Psychiatric Association of the 1930s deserves any account or acclaim for actual bashful during Hitler’s acceleration to power.” Family therapist William Doherty accurately puts the finishing touches on this part, rounding out beforehand statements about the attainable bloom obligations of brainy bloom professionals, to acquaint the abstraction of the aborigine therapist.
Part Three (The Trump Effect) contemplates the civic acceptation of the Donald’s acceleration to the presidency. The area begins acerb with a affiliate by Betty Teng, a New York City therapist and agony specialist. Teng discusses the triggering furnishings of our president’s amaranthine emesis of advancing statements and aberrant behavior. While some may altercate that labelling Trump’s delinquency as alarming devalues the adventures of PTSD sufferers, I was abiding by her altercation that our Pussy Grabber in Chief is re-traumatizing those who’ve suffered calm corruption and added forms of violence.
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Unfortunately, the average allocation of Allotment Three sags a bit. Your breadth may vary, but I begin the capacity on “Trump Anxiety Disorder” and “Other-blaming” to be too self-helpy for comfort. Additionally, capacity on Trump’s amoroso issues and his advance of birtherism were absorbing but came beyond as digressions from the key theses of Lee’s book.
Happily, this area finishes robustly with some of the best affecting and affecting autograph in The Alarming Case of Donald Trump. Jungian analyst Thomas Singer potently considers the interface amid Trump and the aggregate American psyche. I begin echoes of James Baldwin’s prophetic essays as Singer discussed Trump as the advance of America’s narcissism and sociopathy, advertisement the barrenness of our celebrity culture, our adoration of “success,” and our denial-laden fixation on America’s allegorical innocence.
Polish-born therapist Elizabeth Mika algid me with her brainwork aloft absolutism as a egotistic bunco amid the tyrant, his followers, and their broader society. I’m academic she writes from claimed acquaintance of active beneath dictatorship, as she credibility out that avant-garde tyrants accept accordingly been cancerous narcissists. A “we are so screwed” alarming rose in me, in account Mika’s essay, as it kills any balance fantasies that absolutism can’t appear here. (This affiliate would be agreeably complemented by perusing that added must-read of 2017, Holocaust historian Timothy Snyder’s On Tyranny.)
Offering a barrier adjoin bleak despair, Allotment Three concludes with a pragmatic, action-oriented article by psychiatrists Nanette Gantrell and Dee Mosbacher. With lawyerly exactitude, they accomplish their altercation for Trump’s grave crisis to civic security, requesting Congress to act anon aloft Area 4 of the 25th Amendment, to formally assemble an candid console to appraise the president’s brainy fettle for duty. I can alone achievement that some of our assembly will apprehend this.
Though The Alarming Case of Donald Trump is not absolutely a active bank read, I’m assertive that anyone who is psychologically analytical will acquisition it accessible, profiting from time spent with it. With the all-knowing gaslighting by Trump and his about asleep sycophants, there is immense account to conceptualizing and accordingly compassionate the psychopathology at the amount of this administration. Where the APA is AWOL on its charge to America’s attainable bloom at this acute juncture, Lee and others like her accept taken up the all-important slack. And aloof as endless patients accept thanked me for defining their ailments and advance of treatment, allotment the agony and ache inflicted by Trump will be ameliorative for many.
With its accusation of the abhorrence of the APA administration – accurately labelling them as Trump enablers and comparing them to Nazi physicians – it’s ambiguous this book will win any converts amid the cravens currently aloft the APA hierarchy. Instead, it is my achievement that rank-and-file APA associates who still feel abashed by the Goldwater Aphorism will be abiding to act on the added acute ethical obligation to use their specialized ability and acquaint the American attainable of the growing crisis airish by Trump’s cerebral instability.*
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*Public account announcement: If brainy bloom professionals account this accept not yet added their names to the Assignment to Acquaint address (now with over 63,000 signatures), amuse do so here. And amuse appear a Assignment to Acquaint Town Hall on October 14th (open to all); I’ll be speaking at the one in Chattanooga.
Photo attribution: “Donald Trump” by Gage Skidmore, accountant beneath the Creative Commons Attribution-Share Alike 3.0 Unported license.
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