Sunday, March 15, 2020

What Is Wrong With Him?

                                                                                                written 8 March 2020
                                                                                          published 15 March 2020

            "Since the start of Donald Trump's presidential run, one question has quietly but urgently permeated the observations of concerned citizens: What is wrong with him?"  This is the first line of the inner cover notes on the book "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President", by Bandy Lee, published in 2017.
            Psychiatrists have a code of ethics which prohibits diagnosis without detailed personal examination.  The so called "Goldwater rule" states "it is unethical for a psychiatrist to offer public opinion on a public figure without examination."  But, like physicians, they have an obligation to the welfare of the larger society, and are mandated to report, or incapacitate, a person who poses a danger. "Dangerousness" evaluates how the individual acts, not why they act as they do, and an assessment can be made without a clinical diagnosis of the underlying cause.  Thus, a person can be disarmed, incarcerated, or protected, if their actions are a danger to themselves, their family, or their community. 
            In April, 2017, a symposium was held, and "The Dangerous Case" is a publication of the proceedings, with two presentations excerpted here.
            Zimbardo and Sword: "Unbridled and Extreme Present Hedonism."
            "An extreme present hedonist will say or do anything at any time for purposes of self-aggrandizement, with no thought of the future effects of his actions.  Impulsive thoughts lead to an impulsive action that can cause him to dig in his heels when confronted with consequences."  
            "Narcissistic people think very highly of themselves, simultaneously thinking very lowly of everybody else.  Narcissists are emotional, dramatic, and lack compassion and empathy.  What lies underneath narcissist personality type is very low self-esteem, unable to handle criticism of any kind, becoming enraged or condescending."
            "When an individual is psychologically unbalanced, everything can fall apart.  We are gravely concerned about Trump's abrupt, capricious 180-degree shifts and how these displays of instability have the potential to be dangerous to the point of causing catastrophe."
            Schwartz: "I Wrote The Art Of The Deal."
            "Trump's sense of self-worth is forever at risk. When he feels aggrieved, he reacts impulsively and defensively, constructing a self-justifying story that doesn't depend on facts and always directs the blame to others.  Many of the deals in The Art Of The Dealwere massive failures, but Trump had me describe each of them as a huge success.  Trump doesn't value empathy, generosity, reflectiveness, or an inner sense of right and wrong.  Facts are whatever Trump deems them to be on any given day.  His aim is never accuracy; it's domination.  He reacts rather than reflects, and damn the consequences.  This is what makes his access to the nuclear codes so dangerous and frightening.  The more he feels at the mercy of forces he cannot control, the more resentful, desperate, and impulsive he becomes."
            The COVID-19 outbreak is beyond Trump's control. Trump's reaction has been to minimize the risk, which he views as an attack on his presidency.  Last week the president claimed that the virus would “go away” once the weather gets warmer. “We’re probably down to about 10 cases."  Instead, it has increased around the world, with cases now in 104 countries, up from 66. In the US, the case count has jumped from 73 to 474 (with 22 dead), and is now in 33 states.  The US has tested only 5,800 people so far, while South Korea tests more than 10,000 every day.  
            When the head of the National Institute of Allergy and Infectious Diseases said it could be up to 18 months before a vaccine is available, Trump responded: “I mean, I like the sound of a couple months better.”  Trump then said the World Health Organization’s figure of a coronavirus death rate of 3.4% is “really a false number” and that his “hunch” is that the level is “way under 1%.” 
            After the Center for Disease Control urged employees to stay home if they are sick, President Trump said he believes people infected with coronavirus may get better "by going to work."
            Trump plays a president on TV, but his mental condition precludes him being a real leader at a time when the country needs one.  As the virus spreads, Trump will get more unstable.