that'll leave a mark

I've said before I'm conflicted about breaking The Goldwater Rule too, and I won't claim anything about Trump. But one absolute aspect of Narcissistic Personslity Disorder is that it's a massive defense AGAINST suffering. The need for constant shoring up and feeling superior quite effectively masks those feelings. It's an old saw that people with that disorder don't voluntarily come to therapy and I can tell you they're miserable to treat. You've never been sneered at as a professional the way someone with NPD sneers at you. They tend to use you as they do others, to get what they want and then to look down on you for giving it to them, or not, or for how you look, talk, or how the office is decorated.

And he didn't write it. He chaired the task force. And there's a new edition. I'd have to go see if it's different.

And the DSM is American. There's a whole nother book, the ICD, that's used in other countries and sometimes things vary.

This is by way of saying the profession is fluid, we do the best we can, and we argue. I'm sorry about all of those things but I also hate to see absolutes in an inexact field.

I'm glad he wrote the letter pleading for a political solution, but you're right. He alone didn't write the criteria.

I think Trump is probably suffering (from all reports) but he blames the media, Democrats, etc etc etc rather than himself. Trump would never go for help. He would resign before he does that and go play golf for the rest of his life.

About general ethical standards to which he refers, but elsewhere I read that the Goldwater Rule applies only to members of the Am Psychiatric Assn and not to those in the Am Psychological Assn or other orgs.

I do think he made a good point about how we laypeople have a tendency to blame bad behavior on mental illness and how unfair this is to those who suffer with it and do not engage in bad behavior.

There are good arguments to be made for not exposing yourself to public scrutiny out of respect for your patients but if you didn't no books would ever be written. And these days getting Googled by a patient is ubiquitous. That said I wouldn't diagnose anyone without them or a court asking me to. THAT said we talk all the time about what greater good could come from cautioning the public. There's no good way. Asking for caution w/o a diagnosis is imo the only way to talk to whatever random people might be reading it.

And MAN I agree on blaming bad behavior on something that is then called mental illness. Especially kids and adolescents. Perfectly normal adolescents can be DICKS. LOL! Typically they do what they need to do, mature. Making a crucible for that can be a great thing. Sometimes it needs addressing in other ways.

In some ways easier. The goal was for it to be compliant with ICD-10 codes but they ran out of money and released it early. Not sure I dealt with a lot of NPD folks but lots of borderlines. They were always interesting, if nothing else.

You know that. I've known some absolutely wonderful if complicated people with all manner of diagnoses. I've often said to people "I might give you a diagnosis because we need it for insurance or meds or to help others understand. But I don't treat a diagnosis. I treat a person."

I'm actually on sabbatical right now too and it's funny how this makes me want to get back in the saddle. Hate the paperwork, love the people.

I had a hunch they were miserable to treat, or even if they'd allow it without some sort of promise or bribe.

I had mentioned to a skeptical friend that someone like DT wouldn't seek treatment because he isn't financially desparate and needing to get along with others to keep a job.

I noticed the statement that he "wrote" the criteria and it struck me as unnecessary hyperbole. (Almost.... narcissistic.)

I agree with others in this thread who note that it is fair to point out that calling Trump "mentally ill" needlessly insults many other people who are mentally ill, but I find the letter writer's insistence that Trump does not have narcissistic personality disorder illogical. If it's wrong to armchair diagnose an illness, isn't it equally wrong to diagnose a lack of illness? The letter writer hasn't examined Trump, I assume, so how does he know whether or not Trump suffers distress?

The larger point is well taken - Trump's diagnosis or not is beside the point. He's in the White House now, and the solution for that is political.

That's the problem. He is not suffering.

If he were suffering, he would have some empathy, maybe even a lot. He has none.

the pain and not die. To suffer from being merely human and to realize that they are indeed lovable in all their flawed, limited, mistake-making glory. A great psychoanalyst is best known for saying "We are all more simply more human than otherwise." But sometimes that feels as though that vulnerability will surely result in unbearable shame, rejection and utter falling apart.

I wouldn't trade places for the world.

Trump is still litigating the election, making false assertions that he "really" won the popular vote, and that millions of illegal immigrants gave Hillary the popular vote.

Sounds to me that the fact that Hillary was more popular than he was is causing him distress, and that he is severely impaired in that he can't stop talking about that one issue over 3 months after winning* the election.

Not to mention that he needs rallies to help him maintain his confidence.

I am not a psychiatrist, but I"m beginning to think that I, and you, know more about Trump from mere observation than Brownlow does.

experiences it.

I'm just a layperson, and my knowledge comes from lots of reading, talking to other victims of NPD's, BPD's and Psychopaths and vaaaasssst personal experience. Lol.

So, everything I know says they don't suffer and they're not well-meaning or harmless, as the article claims.

The ppl with these personality disorders may suffer from burning anger and emptiness, but they don't experience the kind of pain that makes people seek help. And they certainly cause pain for others, that's a hallmark.

Personally I think there's an emotional disorder going on, rather than a mental illness, since they're in touch with reality enough to know they aim to subvert it. They know very well how reality works and how to manipulate people's perception of it.

They've developed ossified defense mechanisms that prevent them being affected by the pain they cause others, or from the rejection they experience when ppl inevitably get sick of them.

No bonds, no pain of broken bonds. Other people aren't people, just objects, therefore no repentance over harm done.

Meaning it all depends on how the definition of a mental problem is written, and if the book of definitions used by Mental Health people covers his symptoms.
( at one or perhaps more times, it did not)

So, technically, if the person does not seem to suffer from the symptoms, the diagnosis does not technically apply, it appears.
Same with the law, which is why we have dozens of definitions for murder.

In the case of Trump's well known symptoms, he has no self defined problem, does not ask for help/treatment, so tis best to let the legal
arena decided how to handle the the several laws he seems to have broken.

Irony of ironies, let's say he is arrested, charged.
his defense could be ....mental illness.
Certainly provable in that situation.

can't have narcissistic personality disorder unless he experiences distress from it.

Most narcissists don't go to psychiatrists -- because they aren't distressed by it. They instead distress the people in their lives.

And I disagree that DT doesn't show "impairment." He is obviously impaired.

these criteria were designed to diagnose mental issues in order to better treat patients and in some cases determine competency, e.g., to stand trial.

this has little to nothing to do with the mental capacity and stability and health needed to run a nation.

there's little doubt that some presidents have had mental issues. you almost have to be a narcissist and have delusions of grandeur to even run for president, and perhaps sociopathy helps as well. bipolar disorder can work to a politician's advantage as well.

but the fact that these issues have, in some cases, been rewarded instead of punished doesn't change the mental issue.

would that technically, from a psychiatrist's perspective, negate a diagnosis? i'm not a professional, so i can't comment. i can see that a patient might not want treatment for a mental condition which he might "have" but is not "suffering from". that said, for a number of mental conditions, it's the people around the one who "has" the condition who are doing the actual suffering.

in any event, i am a citizen, so i can certainly comment that the exact technical diagnosis isn't a gating criterion for impeaching/removing or invoking the 25th amendment.

[center][font size = "+1"]Дональда Джона Трампа (Donald John Trump) is a Danger to Others.[/font][/center]

Got it.
Thanks.

....mean....and sadistic.