Expert Opinion: Donald Trump Does Not Have a Mental Disorder

Never before in history have so many commentators prefaced their remarks about a President by saying: “you’d have to ask a psychiatrist” or “I’m not a psychologist.”

I am a psychologist. During the course of a 40 year career, I practiced as a criminal forensic specialist, visiting clients in jails, prisons and asylums, and testifying as an expert witness.

Having worked primarily in the context of active criminal proceedings, I look at diagnostic questions more critically than clinicians credentialed in academia.  

President "My Sick Idea" Trump 
The most prominent voice in the Diagnose-Donald-Now Movement - aside from George Conway, derisively known as Mr. Kellyanne Conway - is that of Bandy X. Lee, respectfully known as a Yale psychiatrist. In 2017, she published essays from 27 assorted mental health experts under the title: “The Dangerous Case of Donald Trump.” 

In Dr. Lee’s book, a number of the experts bandy about words that are associated with different forms of mental illness, but it remains a discussion about character, personality type, temperament, judgment and behavior. Mr. Trump was excoriated on those grounds, but no diagnostic hypothesis emerged. More importantly, no distinct and unequivocal symptom of mental disorder was described. 

The observations offered by these experts involve “psychological character evidence,” which in some cases can be admitted in Court for a legal purpose - a diagnosis not necessarily required. 

The bulk of my work involved competency and sanity cases, where a specific diagnostic question must be answered: is the relevant impairment the result of a psychiatric illness (a “disease, disorder or defect” under the law) or is it the result of something else?  The psycho-legal question to be answered is binary: mental disorder, yes or no?

No one has suggested that the President displays symptoms of psychotic thought disorder such as loose associations or hallucinations. And despite living in a world of alternative facts, he is not obviously delusional. Narcissistic grandiosity is not the same as an actual “delusion of grandeur,” and besides, too many other people share his contrived beliefs. 

With respect to the President’s “high energy” presentation, his agitation is nothing like a case of major affective disorder or manic illness. Psychologist John Gartner (one of the 27 experts) cautioned against drawing that conclusion, noting that a “hypomanic temperament” is not the same as clinical hypomania. 

Absent symptoms of a formal thought disorder or a major mood disturbance, the binary answer would be: No, Trump does not have a mental disorder. 

With respect to the President’s narcissism, a personality style is not a DSM personality disorder unless it causes clinical distress or dysfunction - no matter how malignant the character traits. In any case, a personality disorder is not a psychiatric illness. "Sick ideas" are not the same as "crazy thoughts."

With respect to the President’s judgment, there seems to be no evidence that Trump’s IQ falls anywhere above the mean. He does not have a sophisticated vocabulary, or advanced comprehension and reasoning abilities. He has apparently not mastered any formal body of knowledge. 

The intellectual demands of the Presidency are such that if an unstudied person of average IQ tried to do the job, they would naturally end up looking like a moron. That has nothing to do with mental disorder. If an assertion is foolish, we should simply assume it was produced by a fool.

My view is that a “serious inquiry about this man’s condition of mind” (George Conway’s words) should take into account the following considerations.

1. The range of aberrant thought and repulsive behavior that can be explained by personality traits is vast. However, a character pathology is not a mental illness. A psychopath might have sick ideas and twisted motivations and still be judged perfectly sane. 

2. Narcissism and sociopathy (i.e., psychopathy) are two sides of the same coin. The psychopath cares nothing about others. The narcissist cares only about himself.

3. No matter how brilliant the scam or how perfect the crime, psychopaths are typically rather dumb. Exploiting fear or desire in others requires only a limited skill set (mostly interpersonal), but brain power not so much. At the very least, most sociopaths seem to think they will never be caught and that others can always be blamed. They are generally not smart enough to know that you can’t fool all of the people all of the time. 

For those who wonder about the President’s condition of mind, George Conway offered his lay opinion: “it’s nuts, it’s a disorder." 

In the President’s defense, I would disagree with the second half of that statement. 

Copyright, Paul G. Mattiuzzi, Ph.D.


Is Donald Trump a moron? 27 experts fail to answer the baseline question.

Book review (originally published at Amazon):

It turns out that the 27 psychiatrists and other experts represented in this collection of essays did not produce any consensus opinion or “assessment” of Donald Trump’s mental health. Instead, they have shared individual perspectives, integrated primarily around the alarm, distress, disgust, angst, fear (and loathing) they all seem to feel in reaction to the President.

To the extent that a unified psychological profile emerges from these essays, the formulation is lacking any comment on the President’s intelligence - a foundational psychodiagnostic measurement. From a clinical perspective, nothing about his behavior should be interpreted without first answering the baseline question: is Donald Trump a moron?

The experts here are silent on the intelligence question.

Psychiatrist David M. Reiss identified “innate, baseline, intellectual/cognitive skills and ability” as one of five areas of concern regarding “the cognitive abilities of a POTUS.” He concluded, however, that no standards exist for measuring the I.Q. of a politician, and therefore, when it comes to this question, differentiating objective opinion “versus politically based propaganda is an insurmountable problem.”

A concern about an appearance of bias did not stop the other essayists from outlining the now-familiar contours of Trump’s personality type and temperament.


Expert opinion: Donald Trump does not have a personality disorder

Special to The Bee

Personality and character are always at issue in a presidential election, as is the sanity of the candidates. When a contender is referred to as a madman or lunatic, the comment is usually understood to be hyperbole.
No one has accused Donald Trump of hearing voices or howling at the moon. However, many have called him a narcissist.

I have qualified in court as an expert in the psychodiagnostic arts. In prisons and in jails, I commonly encounter narcissists, owing to the fact that clinical narcissism is a core component of the psychopathic mind and sociopathic character.
As an expert in diagnosing disturbances of mind, emotion and character, I can state confidently that Donald Trump does not have narcissistic personality disorder – a condition listed in the psychiatric Diagnostic and Statistical Manual.


The "Too Good Be True Test" is a Worthless Aphorism

When it comes to avoiding scams, schemes and other rip-offs, there is no more universal piece of advice than: "if it's too good to be true it probably isn't." This is usually said after someone has been victimized.

Most everyone is familiar with this pithy observation - an aphorism with a ring of truth to it - but it is familiar only because the warning so persistently fails to prevent people from jumping into the quicksand.

In hindsight, it is easy to see that relative to the cost and risk involved, the expected gain was unrealistic. In the rear view mirror, it is obvious that the promises were extravagant, false and empty.

To know whether something is true and to be trusted, we are told that all you have to do is measure how good it is.

The problem is that "goodness" is not a valid or reliable measure of truth. 


Do Psychopaths Genuinely Lack Empathy, Or Are They Feeling You?

The most common observation made about psychopaths is that they feel no empathy. I have said it myself in Courtroom testimony, repeating a truism I picked up years ago: "they fail to empathize and are therefore prone to victimize."


Psychopath or Sociopath? It Makes no Difference What you Call Them

Originally published at The Huffington Post.

From the earliest days in my career as a criminal forensic psychologist, I have encountered treatises and learned discussions about the difference between psychopaths and sociopaths. Still, to this day, I have never had reason to use the terms, other as than as synonyms.


The Stanford Prison Experiment (2015) Movie Trailer: An Allegory for the APA Ethics-Torture Fiasco

The Stanford Prison Experiment (2015) Movie Trailer: An Allegory ...

Originally published at The Huffington Post-Jul 30, 2015

On July 10, 2015, the American Psychological Association (APA) released The Hoffman Report, an independent investigation into the ethics and behavior of psychologists and the Association, relative to the Bush-era CIA "torture" experiments.
A week later, by coincidence, director Kyle Patrick Alvarez's film The Stanford Prison Experiment (2015) was released in theaters. The movie is billed as an accurate portrayal of a famous 1971 research project that was conceived and overseen by Stanford psychology Professor Philip Zimbardo.


4 Fs of Stress: Beyond Fight or Flight

Originally published at The Huffington Post

The "fight or flight response" is routinely invoked as a shorthand way of explaining that psychological stress involves activation of the sympathetic division of the autonomic nervous system. Too often, the explanation ends there, with the implication that this form of arousal is a bad thing.


Meaning and Purpose in Life: Commonplace or Hard to Come By?

Originally published at the Huffington Post.

In all cultures and at all times, humans have sought to make sense of their existence. Man's search for meaning is a quest as ancient as the dawn of human consciousness.

For at least 100,000 years, humans have buried the dead with rituals and with artifacts, apparently believing that life involves something more than just running from the lion, hunting, gathering, and mating.
It is well established that a sense of purpose is necessary for psychological health, and in turn, for human adaptation and survival. If life did not seem worth it, our ancestors may have given up on running from the lion. If depressed, they may have been less enthusiastic about mating.

Pouring Salt on the Wound: Psychologists Identify the Effects of 'Institutional Betrayal'

Originally published at the Huffington Post.

Women exposed to sexual assault in the military suffer more trauma-related symptoms than female veterans sexually assaulted in civilian life. Children abused only in residential care settings are more likely to have difficulties as adults than children who were abused only at home.
Those are the findings from two studies that have helped define the role of "institutional betrayal" in the experience of traumatic stress.
Summarizing the literature in the September edition of the American Psychologist(the flagship journal of the American Psychological Association), Carly Parnitze Smith and Jennifer J. Freyd state conclusively that institutional attitudes, priorities and behaviors significantly influence the development of post-traumatic distress.