Tuesday 25 June 2019

President Trump does not have the monopoly on narcissism in politics

Mind matters

US President Donald Trump takes the oath of office during his inauguration at the U.S. Capitol in Washington, U.S., January 20, 2017. REUTERS/Kevin Lamarque
US President Donald Trump takes the oath of office during his inauguration at the U.S. Capitol in Washington, U.S., January 20, 2017. REUTERS/Kevin Lamarque

Patricia Casey

Two professors of psychiatry and one assistant professor had the temerity to write to President Obama last month to ask that he request a psychiatric assessment of Donald Trump.

They said they believed the then president-elect had narcissistic personality disorder. According to them, he met the criteria set out in the Diagnostic and Statistical Manual (the tome that details the symptoms required to make a psychiatric diagnosis in the US).

While they pointed to the dangers of making diagnosis without meeting the individual, they nevertheless made this request based on their belief that Trump meets the criteria set out for this disorder and questioned his fitness for office.

A Huffington Post journalist interviewed some psychiatrist and psychologists and stated "virtually every mental health professional… believed with 100pc certainty that Mr Trump satisfied the DSM criteria for this incurable illness... a serious danger to the country and the world".

Here are some memorable quotes to illustrate the thinking of a narcissist: "This is the moment we will see the rise of the oceans began to slow and our planet began to heal" or "a light will shine down from somewhere, it will light upon you, you will experience an epiphany and you will say to yourself 'I have to vote for Barack'."

Yes these grandiose words are those of Obama. Yet professors of psychiatry had not called for his psychiatric evaluation, or expressed any concern that he was a danger to the country because of his possible narcissism.

Such opprobrium is one sided and unidirectional (from left to right). Narcissism is rife in politics and to label that as an illness is an example of the medicalisation of everyday flaws, of the grossest kind.

What is narcissistic personality disorder anyway? I have never made this diagnosis because it betrays a very simple misunderstanding about the nature of mental illness and personality disorder in particular.

There is a flawed assumption that these labels represent some clear entity occurring in nature that constitutes an illness, like say, tuberculosis or rheumatoid arthritis. You either have it or you don't, you can measure it biologically and it has a particular course and response to treatment. Personality disorder has none of these attributes, and is nothing more than a description of personality traits that occur in the general population who would not be diagnosed with any psychiatric condition but for the fact that it impacts negatively on relationships.

There is no clear demarcation between these traits and those diagnosed with a personality disorder, apart from the impact others. Many of the personality disorder categories that are used in psychiatric jargon have not been shown to be specific, and discrete entities and narcissistic personality disorder belongs to that group.

Narcissistic personality disorder itself is defined as "a mental disorder in which people have an inflated sense of their own importance, a deep need for admiration and a lack of empathy for others. But behind this mask of ultra-confidence lies a fragile self-esteem that's vulnerable to the slightest criticism".

It has always been a controversial diagnosis and while the American classification includes it, the World Health Organisation International Classification of Diseases does not. This is used in Europe. Even in the US, there are many who question the recognition of narcissistic personality disorder as a mental disorder.

Sure, Obama and Trump are both narcissists. That does not equate with mental illness. The world of fashion, of movie stars, pop stars and celebrities are also fertile breeding grounds for narcissism. The cult of personality, whether it be Barack Obama, the Kardashians or Kim Jong Il stimulates popular worship that fans grandiose self- regard.

Donald Trump is a bombast, loud and shrill with a very large ego. I do not subscribe to the idea that he or Barack Obama have a personality disorder, as has been suggested of both; this has been infinitely more voluble regarding Trump through the prism of political disdain.

The Diagnostic and Statistical Manual, to which the three psychiatrists referred in their letter, is often referred to as the Bible of Psychiatry. That is an apt comparison. It should be treated in the same manner that the Bible (unfortunately) is by many and that is with complete and utter disregard.

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