Over 60,000 licensed mental health professionals have signed petitions calling for the mental examination of President Donald J. Trump. (Change.org — over 70,000; CitizenTherapists.com — over 3,000) Diagnosis-at-a-distance is a questionable practice. Accuracy is difficult if not impossible, a fact clearly demonstrated by the variety of diagnoses already suggested in the press, which include: schizophrenia, paranoia, ego-deficiency, narcissism, sociopathy, malignant sociopathy, psychopathy, antisocial personality disorder.
What exactly is Trump’s problem?
Consensus among therapists as to exactly what is Trump’s specific mental disorder has not and will not be achieved until Trump is personally examined by experienced psychologist and/or psychiatrists. Still, it is clear that the therapeutic community is in wide agreement that something is seriously wrong with his mind and/or personality. These two facts — something is wrong, we can’t agree upon what it is — strongly supports my position that Trump must be examined by mental health professionals as soon as possible, before he does something irreversible and world-changing.
Based upon my reading of his speeches and tweets and observing his mannerisms, It is my position that Trump is a Psychopath. The rest of this piece and the following pieces are support for this position.
Most people know little about psychopathy beyond what they encounter in books and films. They imagine that all psychopaths are the vicious murders or serial killers typically depicted. This is far from the truth.
The Hare Psychopathy Checklist - Revised Version (PCL-RV) was developed by Robert Hare, PhD, to assess people accused or convicted of crimes, in order to rate on a scale the severity of their psychopathic or antisocial tendencies, if any. It consists of 20 criterion, which are rated during an extensive interview with the inmate. Each criterion is rated 0 — Does not apply, 1 — applies somewhat, 2 — Applies fully. Top score (severe psychopathy) is 40 points. A score of 30-40 indicates psychopathy, 20-29 antisocial or “sociopathy,” below 20 is the normal range. Most people score close to 5. That alone should give you a feeling for just how different psychopaths are from the rest of us.
As with the stereotypical medical student studying diseases and their symptoms, it’s common when first reading the criteria and their descriptions to think, “Help, I have all these symptoms!” The rule of thumb is: if you’re afraid you might be a psychopath, you’re not a psychopath. A true psychopath doesn’t care if others think he’s disordered, has no empathy and no conscience. He knows he’s superior to all others, whatever they might say. Empathy and conscience are for losers and victims and prey, not for winners.
The shorter 12-item Screening Version (PCL-SV) is the primary tool used for diagnosing psychopathy in the general population and - for criminals – is used as a preliminary screen for the PCL-RV. When discussing Donald Trump, it is appropriate to use this version as it does not utilize criteria inapplicable to incarceration criminals.
How Common Are Psychopaths?
According to Robert Hare, about 1 percent of all people test as psychopathic by these diagnostic tools; the rate of male psychopathy is a bit higher than for women. About one percent of psychopaths are violent. Ten to thirty percent of convicts are psychopaths; male convicts are psychopathic at a higher rate then women. The rate of psychopathy among business managers and corporate executive is unknown but estimated to be much higher than among the general population. Politicians haven’t been studied as a group, but we should expect a rate of psychopathy similar to executives.
Harvard Medical School associate professor of psychiatry Ronald Schouten and former federal prosecutor and current criminal defense attorney James Silver estimate in their book “Almost a Psychopath” that 5 — 15 percent of us are “almost a psychopath;” they would score lower on the psychopathy checklists than full-blown psychopaths, but higher than would “neurotypicals.”
With one percent of the population being psychopaths, you have undoubtedly already encountered some, but lacking knowledge of the criterion of psychopathy, you would not know what their “deal” was. They might seem cold, calculating, fake, unempathetic, frequent liars, outstanding at “pushing your buttons” and frequently doing so, and always out to get something from you. If you distrusted them and did your best to avoid them, you were smart.
Using the PCL-SV as the basis for my analysis, we’ll go through the twelve criterion, citing examples of Trump’s behavior.
The Mental Health Profession and Trump
In 1973 the American Psychiatric Association adopted the “Goldwater Rule”, which says that a psychiatrist may:
“…share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”
The profession still adheres to this rule, although the seriously disordered nature of Trump’s behavior is beginning to crack this wall. It is because of this rule that psychiatrists — and the entire mental health profession — has been very reticent to voice their opinions about Trump.
Whatever the composition of the group of mental health professionals who examine Trump, it must include therapists experienced with Personality Disorders (PDs), especially that of Psychopathy. People with PDs must be handled differently from those with neurotic or schizophrenic disorders. Many therapists unfamiliar with PDs will expect that patients “suffer” from their disability. Lacking such “suffering” or “discomfort,” there is really nothing wrong with them and they need no treatment. This view does not apply to many people with PDs, especially the narcissism-sociopathy-psychopathy-antisocial group. These people can be perfectly happy with themselves, fully believing that not only is nothing wrong with them, it’s everyone else who is defective. Meanwhile, they create misery and destruction among the unfortunate who encounter them.
Hare Psychopathy Checklist — Screening Version and Trump
The criteria of psychopathy falls into four groups, which we’ll cover in four following blogs, citing Trump from his own speeches and tweets, and from opinions of those who know him well.
- Part II: The Interpersonal Dimension — Glib and superficial charm; Grandiose self-worth; Pathological lying, conning and manipulativeness
- Part III: The Affective Dimension — Lack of Remorse or Guilt; Shallow Affect, Callousness and Lack of Empathy; Failure to Accept Responsibility for Own Actions
- Part IV: The Lifestyle Dimension — Impulsive, seeks stimulation, prone to boredom; Parasitic lifestyle, lack of realistic long-term goals; Irresponsibility
- Part V: The Antisocial Dimension — Poor behavioral controls; Adolescent antisocial behavior; Adult antisocial behavior
The Entire Series
Link to Part I: Trump — Our Psychopathic President
Link to Part II: Trump — Our Psychopathic President: His Interpersonal Dimension of Psychopathy
Link to Part III: Trump — Our Psychopathic President: His Affective Dimension of Psychopathy
Link to Part IV: Trump — Our Psychopathic President: His Lifestyle Dimension of Psychopathy
Link to Part V: Trump — Our Psychopathic President: His Antisocial Dimension of Psychopathy
Link to Part VI: Trump — Our Psychopathic President: Summing Up Trump
Our Other Daily Kos blog reports:
The Nine Principles of Propaganda begins HERE.
The Nine Principles of Counterpropaganda begins HERE.
Recommended Reading
Without Conscience: The Disturbing World of the Psychopaths Among Us. Hare, Robert D., PhD. 1993; New York: The Guilford Press
Snakes in Suits: When Psychopaths Go To Work. Babiak, Paul, Ph.D. & Hare, Robert D., Ph.D. 2006. New York, Regan Books–Harper Collins Publishers
Cooke, David J., Michie, Christine, Hart,Stephen David & Hare, Robert. (1999). Evaluating the Screening Version of the Hare Psychopathy Checklist-Revised (PCL-SV): An Item Response Theory Analysis. Psychological Assessment, Vol. II, No. 1, 3-13.